Individual
MISS PRISCILLA RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
6918 W ARCHER AVE, CHICAGO, IL 60638-2337
(773) 667-3508
Mailing address
PO BOX 746715, ATLANTA, GA 30374-6715
(773) 352-1515
(312) 929-0373
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
277.003527
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F400179195
MEDICARE PTAN
—
Enumeration date
08/23/2011
Last updated
06/06/2025
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