Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KELLY TAIS AZAMBUJA CACHOEIRA, APRN
ActiveKELLY TAIS AZAMBUJA CACHOEIRA, APRN is a Nurse Practitioner healthcare provider located in BANNOCKBURN, Illinois. NPI 1295599900 is currently active in the NPPES registry. Verify at CMS.
Nurse Practitioner · BANNOCKBURN, IL
Registration Details
- NPI Number
- 1295599900
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Feb 13, 2024 (2.4759372764486 yrs)
- Last Updated
- Aug 7, 2024
- License
-
209029354 (IL)
Practice Information
- Address
-
2151 WAUKEGAN RD STE 100BANNOCKBURN, IL, 600151885Browse IL providers · Browse ZIP 60015
- Phone
- 8474445300
- Primary Specialty
-
Nurse Practitioner
363L00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.