Individual
GILDA GRACE RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5841 S MARYLAND AVE # MC2115, CHICAGO, IL 60637-1443
(773) 702-6149
Mailing address
5841 S MARYLAND AVE # MC2115, CHICAGO, IL 60637-1443
(773) 702-6149
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209024147
IL
Other
Enumeration date
10/21/2021
Last updated
10/21/2021
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