Provider Demographics
NPI:1700351053
Name:VARGAS, IRMA I (FNP)
Entity Type:Individual
Prefix:MRS
First Name:IRMA
Middle Name:I
Last Name:VARGAS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3005 HIGHLAND PKWY
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-5682
Mailing Address - Country:US
Mailing Address - Phone:877-751-5783
Mailing Address - Fax:
Practice Address - Street 1:3005 HIGHLAND PKWY
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-5682
Practice Address - Country:US
Practice Address - Phone:877-751-5783
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-12
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11000142363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner