Provider Demographics
NPI:1518789593
Name:GONZALEZ ARANCIBIA, CONSTANZA (NP)
Entity type:Individual
Prefix:
First Name:CONSTANZA
Middle Name:
Last Name:GONZALEZ ARANCIBIA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 MACDERMOTT DRIVE
Mailing Address - Street 2:
Mailing Address - City:AJAX
Mailing Address - State:ON
Mailing Address - Zip Code:L1T 3T5
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:225 W. WASHINGTON ST.
Practice Address - Street 2:SUITE 1700
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60606
Practice Address - Country:US
Practice Address - Phone:855-493-5523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-30
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.030826363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner