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Individual

ESTRELLA SEPULVEDA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1701 W SUPERIOR ST, CHICAGO, IL 60622-5646
(312) 666-3494
Mailing address
2009 W CONCORD PL, CHICAGO, IL 60647-5526
(219) 588-2655

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209.015872
IL
363LP2300X
Primary Care Nurse Practitioner
Primary
209015872
IL

Other

Enumeration date
07/05/2017
Last updated
08/10/2021
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