DEBORA DELRE (NPI# 1780048058) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780048058 |
| Entity Type | Individual |
| Full Name | DEBORA DELRE |
| Credential | APN, PMHNP-BC |
| Practice Address |
12255 S 80th Ave Suite 202 Palos Heights IL 60463-1258 |
| Mailing Address |
12255 S 80th Ave Suite 1630 Palos Heights IL 60463-1258 |
| Practice Telephone | 7089237878 |
| Practice Fax Number | 7089237888 |
| Mailing Telephone | 7089235173 |
| Mailing Fax Number | 7089235018 |
| Enumeration Date | 2016-04-12 |
| Last Update Date | 2017-02-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
209014185 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | MEDICARE PTAN | F400292315 | 01 |
| Street Address |
12255 S 80TH AVE SUITE 202 |
| City | PALOS HEIGHTS |
| State | IL |
| Zip Code | 60463-1258 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356330286 | Bruce R Dolitsky | Orthopaedic Surgery | 12255 S 80th Ave, Palos Heights, IL 60463-1270 | 2005-10-13 |
| 1699387910 | Wilma Montilla-rener | Nurse Practitioner | 12255 S 80th Ave, Palos Heights, IL 60463-1270 | 2020-08-18 |
| 1306203757 | Shelley Kay Mayer-zich | Nurse Practitioner | 12255 S 80th Ave, Palos Heights, IL 60463-1270 | 2016-01-15 |
| 1881078392 | Radhika Chimata | Psychiatry & Neurology | 12255 S 80th Ave, Palos Heights, IL 60463-1270 | 2015-07-14 |
| 1548640535 | Talha John Baloch | Psychiatry & Neurology | 12255 S 80th Ave, Palos Heights, IL 60463-1270 | 2015-06-04 |
| 1326482688 | Anmol Tolani | Psychiatry & Neurology | 12255 S 80th Ave, Palos Heights, IL 60463-1270 | 2013-04-17 |
| 1558625251 | Anthony Casini | Surgery | 12255 S 80th Ave, Palos Heights, IL 60463 | 2012-06-27 |
| 1548532591 | Darlene C Flowers | Nurse Practitioner | 12255 S 80th Ave, Palos Heights, IL 60463-1270 | 2012-02-07 |
| 1760776173 | Imad Qayyum | Surgery | 12255 S 80th Ave, Palos Heights, IL 60463-1270 | 2011-06-02 |
| 1720243025 | Sameen Ahmad | Psychiatry & Neurology | 12255 S 80th Ave, Palos Heights, IL 60463-1270 | 2008-07-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932756095 | Kim Rusiecki | Technician | 25 Parliament Drive East, Palos Heights, IL 60463 | 2019-08-23 |
| 1265925218 | Sentinel Anesthesia of Illinois, PC | Anesthesiology | 7340 W College Dr Fl 1, Palos Heights, IL 60463 | 2018-06-13 |
| 1225410848 | Deborah Ann Castaneda | Skilled Nursing Facility | 12350 Natchez Ave., Palos Heights, IL 60463 | 2015-06-19 |
| 1609253160 | Tareq Ayyad | Physical Therapy Assistant | 11730 Lighthouse Ln, Palos Heights, IL 60463 | 2015-05-04 |
| 1366846503 | Ryan Teahen | Dentist | 7600 W College Dr Ste 17, Palos Heights, IL 60463 | 2014-10-17 |
| 1295140309 | Paul Park | Ophthalmology | 7600 W College Dr Ste 9, Palos Heights, IL 60463 | 2014-06-26 |
| 1275976045 | Nazim A. Khan | Physician Assistant | 6450 West College Drive, Palos Heights, IL 60463 | 2013-04-11 |
| 1619246824 | Amanda M Ejka | Psychologist | 11800 South 75th Avenue, Suite 300, Palos Heights, IL 60463 | 2011-12-16 |
| 1578832937 | Sandi Maheras | Pharmacist | 1703 Spyglass Cir, Palos Heights, IL 60463 | 2011-12-14 |
| 1043597065 | Ashraf Olwan | Pharmacist | 7660 W Sequoia Rd, Palos Heights, IL 60463 | 2011-11-04 |
| Find all providers in zip 60463 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699387910 | Wilma Montilla-rener | Nurse Practitioner | 12255 S 80th Ave, Palos Heights, IL 60463-1270 | 2020-08-18 |
| 1003352196 | Debora Ellis | Nurse Practitioner | 12251 S 80th Ave, Palos Heights, IL 60463-1256 | 2017-01-12 |
| 1548532591 | Darlene C Flowers | Nurse Practitioner | 12255 S 80th Ave, Palos Heights, IL 60463-1270 | 2012-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790384451 | Ghea Tiping Degillo | Nurse Practitioner | 4711 Golf Rd Ste 500, Skokie, IL 60076-1208 | 2020-10-22 |
| 1750989620 | Rodney J Pena Jr. | Nurse Practitioner | 1362 Trotters Ln, Bourbonnais, IL 60914-4519 | 2020-10-13 |
| 1609482231 | Crystal Lynn Jordan | Nurse Practitioner | 638 Oakbrook Ave, Chatham, IL 62629 | 2020-09-18 |
| 1497369672 | Mojisola Abayemi Akinfe | Nurse Practitioner | 8572 Stone Creek Blvd, Frankfort, IL 60423-9338 | 2020-09-03 |
| 1508475039 | Hilary Eichie | Nurse Practitioner | 20025 Division St., Crest Hill, IL 60403 | 2020-07-30 |
| 1518585942 | Tabs Behavioral Health Inc | Nurse Practitioner | 13316 Vicarage Dr, Plainfield, IL 60585-5050 | 2020-07-13 |
| 1154946788 | Latisha Trenice Stennis | Nurse Practitioner | 8106 Carol Dr, East Saint Louis, IL 62203-1838 | 2020-06-09 |
| 1114549755 | Maria Andreea Bordeianu | Nurse Practitioner | 6050 N California Ave, Chicago, IL 60659-3916 | 2020-05-16 |
| 1104448968 | Abosede Rachel Babalola | Nurse Practitioner | 2214 Monarch St, Bourbonnais, IL 60914-2780 | 2020-05-14 |
| 1659909406 | Mudira Temilola Oyewole | Nurse Practitioner | 493 Leslie Ct, Des Plaines, IL 60016-8818 | 2020-03-28 |
| Find all providers with the same taxonomy | ||||
| City | PALOS HEIGHTS |
| Zip Code | 60463 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.