Provider Demographics
NPI:1699503193
Name:BACHEZ, ADELIE (RN)
Entity type:Individual
Prefix:
First Name:ADELIE
Middle Name:
Last Name:BACHEZ
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 1:1461 S BLUE ISLAND AVE APT 316
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60608-2282
Mailing Address - Country:US
Mailing Address - Phone:310-279-9073
Mailing Address - Fax:
Practice Address - Street 1:1461 S BLUE ISLAND AVE APT 316
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60608-2282
Practice Address - Country:US
Practice Address - Phone:310-279-9073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-25
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.558422163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse