Individual
ERIKA BALBUENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6918 W ARCHER AVE, CHICAGO, IL 60638-2337
(773) 667-3508
(312) 962-4986
Mailing address
PO BOX 746721, ATLANTA, GA 30374-6721
(312) 733-9730
(773) 866-8014
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209.028420
IL
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
06/27/2023
Last updated
10/12/2023
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