Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Alfonso Allan M Balleza II

Individual provider Wound Care Registered Nurse · NPI 1417769803

Mr. Alfonso Allan M Balleza II is a Wound Care Registered Nurse in Park Ridge, Illinois. Licensed in Illinois. Registered with an NPI since 2025.

Licensed in
IL
In the registry since
2025

Practice location Address checks out

1480 Renaissance Dr Ste 211
Park Ridge, IL 60068-1353
Phone: (847) 296-6161
Fax: (847) 296-6262
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Wound Care Registered Nurse (primary) Taxonomy 163WW0000X · Licence 041388781 (IL)

Record details

NPI number1417769803
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJanuary 22, 2025
Last updated in NPPESJanuary 22, 2025
Certification dateJanuary 22, 2025

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