Individual
ELSA VALERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6425 CERMAK RD, BERWYN, IL 60402-2338
(708) 484-0044
Mailing address
6642 PAYSPHERE CIR, CHICAGO, IL 60674-0066
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036119869
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036119869
STATE LICENSE
IL
Enumeration date
04/21/2008
Last updated
04/21/2008
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