Individual
KELLY M. VASQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN-CNP
Contact information
Practice address
314 E WASHINGTON ST, DES PLAINES, IL 60016-3061
(773) 951-4511
Mailing address
314 E WASHINGTON ST, DES PLAINES, IL 60016-3061
(773) 951-4511
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.499075
IL
363L00000X
Nurse Practitioner
Primary
209030756
IL
363LF0000X
Family Nurse Practitioner
209.030756
IL
Other
Enumeration date
08/15/2024
Last updated
05/11/2026
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