Individual
MARIA A RAGUSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPN
Contact information
Practice address
3707 DOTY RD STE H, WOODSTOCK, IL 60098
(815) 338-6600
(811) 533-7549
Mailing address
3707 DOTY RD STE H, WOODSTOCK, IL 60098-7530
(815) 338-6600
(811) 533-7549
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209010997
IL
363LP0200X
Pediatric Nurse Practitioner
Primary
209010997
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209010997
STATE LICENSE
IL
Enumeration date
11/24/2013
Last updated
10/19/2018
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