Provider Demographics
NPI:1295565786
Name:GARCIA, DESIREE-BIANCA SABRINA (APN-CNP)
Entity type:Individual
Prefix:
First Name:DESIREE-BIANCA
Middle Name:SABRINA
Last Name:GARCIA
Suffix:
Gender:F
Credentials:APN-CNP
Other - Prefix:
Other - First Name:DESIREE
Other - Middle Name:SABRINA
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:2650 RIDGE AVE # 1223
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-1700
Mailing Address - Country:US
Mailing Address - Phone:475-702-0408
Mailing Address - Fax:
Practice Address - Street 1:552 S WASHINGTON ST STE 116
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-6678
Practice Address - Country:US
Practice Address - Phone:630-983-5694
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-07
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041368664163W00000X
IL209030235363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily