Individual
ANGEL CUSTODIO HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APN-CNP
Contact information
Practice address
2650 RIDGE AVE., PALLIATIVE CARE, EVANSTON, IL 60201-1718
(847) 503-4222
(847) 503-4220
Mailing address
5218 N KIMBALL AVE, APT. 2, CHICAGO, IL 60625-4729
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209013700
IL
363LF0000X
Family Nurse Practitioner
209.013700
IL
Other
Enumeration date
04/01/2016
Last updated
08/12/2025
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