Individual
RACQUEL DE LOS REYES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
820 S DAMEN AVE, CHICAGO, IL 60612-3728
(312) 569-8387
Mailing address
5634 N CALIFORNIA AVE, CHICAGO, IL 60659-4815
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95055921
CA
163W00000X
Registered Nurse
Primary
95055921
IL
Other
Enumeration date
10/20/2015
Last updated
10/20/2015
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