Provider Demographics
NPI:1154295012
Name:PRECIADO, NALLELY
Entity type:Individual
Prefix:
First Name:NALLELY
Middle Name:
Last Name:PRECIADO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NALLELY
Other - Middle Name:
Other - Last Name:PRECIADO-ESTRADA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2012 HARPER RD
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:IL
Mailing Address - Zip Code:60561-6701
Mailing Address - Country:US
Mailing Address - Phone:217-607-3990
Mailing Address - Fax:
Practice Address - Street 1:2012 HARPER RD
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:IL
Practice Address - Zip Code:60561-6701
Practice Address - Country:US
Practice Address - Phone:217-607-3990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-02
Last Update Date:2025-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program