Brillante, Raquel Tadalan

Brillante, Raquel Tadalan is an individual health care provider with primary practice located at 60 Orland Square Dr , Orland Park IL 60462-6548. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Brillante, Raquel Tadalan can be contacted via phone (708) 226-9055.

Contact Information

Primary practice address
60 Orland Square Dr Orland Park IL 60462-6548
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 209000444 Illinois

Profile Details

NPI number 1053320697
LBN Legal business name Brillante, Raquel Tadalan
Credentials Certified Nurse Practitioner (CNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 5th, 2006
Last updated Mar 7th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053320697 NPPES
Illinois Other 209-000444 CNP LICENSE #
Illinois MEDICAID 209000444 CNP LICENSE #
Illinois Other 309000581 CNP LICENSE #

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