Individual
CLAUDIA MARIELA VASQUEZ PORTILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2233 W DIVISION ST, CHICAGO, IL 60622-8151
(312) 770-2040
Mailing address
2233 W DIVISION ST, CHICAGO, IL 60622-8151
(312) 770-2040
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
125085028
IL
Other
Enumeration date
07/19/2024
Last updated
07/19/2024
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