Individual
MRS. NANCY SLONE RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
15 HOLE IN THE WALL RD, WILMINGTON, IL 60481-8772
(847) 494-3158
Mailing address
1900 SILVER CROSS BLVD, NEW LENOX, IL 60451-9509
(847) 494-3158
Taxonomy
Speciality
Code
Description
License number
State
163WE0900X
Enterostomal Therapy Registered Nurse
209.0065596
IL
363LA2200X
Adult Health Nurse Practitioner
Primary
209006596
IL
Other
Enumeration date
07/23/2007
Last updated
08/04/2021
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