Individual
NUVIA BANUELOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5339 S LAWNDALE AVE, CHICAGO, IL 60632-3238
(224) 200-7054
Mailing address
5339 S LAWNDALE AVE, CHICAGO, IL 60632-3238
(224) 200-7054
Taxonomy
Speciality
Code
Description
License number
State
171R00000X
Interpreter
Primary
B542-6398-9870
IL
Other
Enumeration date
03/01/2017
Last updated
03/01/2017
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