Individual
BIANCA L KAVANAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
28201 DIEHL RD, WARRENVILLE, IL 60555-3934
(630) 657-5555
Mailing address
1530 S STATE ST APT 700, CHICAGO, IL 60605-2976
(312) 590-2258
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041352957
IL
363LF0000X
Family Nurse Practitioner
Primary
209008747
IL
Other
Enumeration date
08/15/2011
Last updated
10/29/2014
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