Individual
MAURICIO O PINEDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN, CNP
Contact information
Practice address
1000 N WESTMORELAND RD, LAKE FOREST, IL 60045-1658
(847) 535-6150
(847) 535-7801
Mailing address
1000 N WESTMORELAND RD, LAKE FOREST, IL 60045-1658
(847) 535-6150
(847) 535-7801
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
041.450183
IL
363L00000X
Nurse Practitioner
Primary
209025355
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209025355
STATE LICENSE
IL
Enumeration date
06/01/2022
Last updated
11/21/2023
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