Provider Demographics
NPI:1447679642
Name:CAMACHO, ESPERANZA (RN)
Entity type:Individual
Prefix:MRS
First Name:ESPERANZA
Middle Name:
Last Name:CAMACHO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25841 GERANIUM LANE
Mailing Address - Street 2:
Mailing Address - City:MONEE
Mailing Address - State:IL
Mailing Address - Zip Code:60449
Mailing Address - Country:US
Mailing Address - Phone:815-258-1571
Mailing Address - Fax:
Practice Address - Street 1:25841 GERANIUM LANE
Practice Address - Street 2:
Practice Address - City:MONEE
Practice Address - State:IL
Practice Address - Zip Code:60449
Practice Address - Country:US
Practice Address - Phone:815-258-1571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-15
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041274152163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse