Individual
KEVIN P VEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
120 S MARION ST, OAK PARK, IL 60302-2809
(708) 383-7500
Mailing address
120 S MARION ST, OAK PARK, IL 60302-2809
(708) 383-7500
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14962015
CAQH
—
Enumeration date
05/25/2021
Last updated
05/25/2021
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