Individual
MS. VIBE PEARL L GUILLERGAN-KUPSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-BC
Contact information
Practice address
6201 W TOUHY AVE, CHICAGO, IL 60646-1100
(847) 673-5166
(847) 462-4411
Mailing address
90 SONOMA DR, ROMEOVILLE, IL 60446-5166
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
41286442
IL
363L00000X
Nurse Practitioner
Primary
209006841
IL
363LA2200X
Adult Health Nurse Practitioner
209006841
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
206147
MEDICARE PTAN (GROUP)
IL
01
—
206147095
MEDICARE PTAN (INDIVIDUAL)
IL
Enumeration date
12/19/2007
Last updated
04/21/2017
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