Individual
MRS. AIRA BASCO ADVINCULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1101 PEMBRIDGE DR, LAKE FOREST, IL 60045-4222
(847) 604-6751
(847) 604-6708
Mailing address
1101 PEMBRIDGE DR, LAKE FOREST, IL 60045-4222
(847) 604-6511
(847) 604-6708
Taxonomy
Speciality
Code
Description
License number
State
163WG0600X
Gerontology Registered Nurse
Primary
041398194
IL
Other
Enumeration date
12/26/2023
Last updated
12/26/2023
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