Individual
FABIOLA NIETO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
4720 S CALIFORNIA AVE, CHICAGO, IL 60632-2016
(773) 584-6200
(833) 449-4168
Mailing address
4720 S CALIFORNIA AVE, CHICAGO, IL 60632-2016
(773) 584-6200
(833) 449-4168
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209022981
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114502259
—
IL
Enumeration date
03/10/2021
Last updated
09/30/2025
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