Provider Demographics
NPI:1255401261
Name:DECROES, CARINA LORETTA (MS, RN, APRN, BC)
Entity type:Individual
Prefix:MS
First Name:CARINA
Middle Name:LORETTA
Last Name:DECROES
Suffix:
Gender:F
Credentials:MS, RN, APRN, BC
Other - Prefix:
Other - First Name:CARINA
Other - Middle Name:
Other - Last Name:SCHWALBE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:600 N MCCLURG CT
Mailing Address - Street 2:#2302A
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3044
Mailing Address - Country:US
Mailing Address - Phone:312-643-0235
Mailing Address - Fax:312-695-6870
Practice Address - Street 1:675 N SAINT CLAIR ST
Practice Address - Street 2:SUITE 21-200
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-5975
Practice Address - Country:US
Practice Address - Phone:312-707-1349
Practice Address - Fax:312-695-6870
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health