Individual
AMY VILLARREAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1122 PORT ROYAL RD, PINGREE GROVE, IL 60140
(224) 639-5018
Mailing address
1122 PORT ROYAL RD, PINGREE GROVE, IL 60140-9196
(224) 639-5018
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
A4554V
IL
Other
Enumeration date
06/15/2007
Last updated
01/08/2026
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