Provider Demographics
NPI:1467294835
Name:HIGHTOWER, ELVIRAIDA (RN)
Entity type:Individual
Prefix:
First Name:ELVIRAIDA
Middle Name:
Last Name:HIGHTOWER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7300 N HAMILTON AVE APT 1N
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60645-6924
Mailing Address - Country:US
Mailing Address - Phone:773-263-1254
Mailing Address - Fax:
Practice Address - Street 1:7300 N HAMILTON AVE APT 1N
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60645-6924
Practice Address - Country:US
Practice Address - Phone:773-263-1254
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041263656163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse