Individual
MARICRUZ DE LA VEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3843 W 63RD ST, CHICAGO, IL 60629-4623
(773) 884-2212
Mailing address
3843 W 63RD ST, CHICAGO, IL 60629-4623
(773) 884-2212
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.103059
IL
104100000X
Social Worker
150103059
IL
Other
Enumeration date
07/29/2019
Last updated
07/29/2019
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