Provider Demographics
NPI:1255923660
Name:RIOS, LUCRECIA (REGISTERED NURSE)
Entity type:Individual
Prefix:MRS
First Name:LUCRECIA
Middle Name:
Last Name:RIOS
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5353 W GALEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60639-2954
Mailing Address - Country:US
Mailing Address - Phone:312-919-3023
Mailing Address - Fax:
Practice Address - Street 1:5353 W GALEWOOD AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60639-2954
Practice Address - Country:US
Practice Address - Phone:312-919-3023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-07
Last Update Date:2021-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041285225163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management