Provider Demographics
NPI:1740680602
Name:NACARATO, DANIAH (APN)
Entity type:Individual
Prefix:
First Name:DANIAH
Middle Name:
Last Name:NACARATO
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:DANIAH
Other - Middle Name:NOELLE
Other - Last Name:ROBB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN
Mailing Address - Street 1:6811 N KNOXVILLE AVE STE A
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61614-2868
Mailing Address - Country:US
Mailing Address - Phone:309-439-9400
Mailing Address - Fax:309-323-0469
Practice Address - Street 1:6811 N KNOXVILLE AVE STE A
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61614-2868
Practice Address - Country:US
Practice Address - Phone:309-439-9400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-28
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209011655363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily