Individual
FAYE GANDEZA IBANEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
5140 N CALIFORNIA AVE STE G115, CHICAGO, IL 60625-4971
(773) 989-3803
(773) 989-3979
Mailing address
2650 RIDGE AVE, EVANSTON, IL 60201-1700
(773) 989-3803
(773) 878-5726
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209018210
IL
363LF0000X
Family Nurse Practitioner
209.018210
IL
Other
Enumeration date
09/20/2018
Last updated
03/21/2022
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