Provider Demographics
NPI:1780425579
Name:ABISTADO, NARWILITO BARRALES (FNP-C)
Entity type:Individual
Prefix:
First Name:NARWILITO
Middle Name:BARRALES
Last Name:ABISTADO
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9234 HARLOWE LN
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-1057
Mailing Address - Country:US
Mailing Address - Phone:708-501-0052
Mailing Address - Fax:
Practice Address - Street 1:5103 W CERMAK RD
Practice Address - Street 2:
Practice Address - City:CICERO
Practice Address - State:IL
Practice Address - Zip Code:60804-2902
Practice Address - Country:US
Practice Address - Phone:708-780-7400
Practice Address - Fax:708-780-7423
Is Sole Proprietor?:No
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209029362363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily