Individual
MS. ROSA L FUENTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
2420 DANBURY DR APT B2, WOODRIDGE, IL 60517-2096
(630) 479-3382
Mailing address
5841 S MARYLAND AVE, CHICAGO, IL 60637-1447
(773) 702-1000
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
209006367
IL
Other
Enumeration date
10/11/2007
Last updated
02/24/2011
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