Individual
VANESSA VAZQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2100 PFINGSTEN RD, GLENVIEW, IL 60026-1301
(847) 570-2860
Mailing address
2650 RIDGE AVE, EVANSTON, IL 60201-1700
(224) 730-9741
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
085011007
IL
Other
Enumeration date
10/18/2024
Last updated
01/30/2025
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