Basic Information
Provider Information
NPI: 1295164077
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LUDOVICO
FirstName: CINDY
MiddleName:  
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Mailing Information
Address1: 25070 NETWORK PL
Address2:  
City: CHICAGO
State: IL
PostalCode: 606731250
CountryCode: US
TelephoneNumber: 8475857000
FaxNumber: 8472409093
Practice Location
Address1: 880 W CENTRAL RD
Address2: STE 8200
City: ARLINGTON HEIGHTS
State: IL
PostalCode: 600052355
CountryCode: US
TelephoneNumber: 8472594482
FaxNumber: 8472596406
Other Information
ProviderEnumerationDate: 11/02/2013
LastUpdateDate: 11/12/2013
NPIDeactivationReasonCode:  
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NPIReactivationDate:  
ProviderGenderCode: F
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IsSoleProprietor: Y
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NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X209010767ILY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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