Individual
MR. LIBIN MANUEL ZEVALLOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
4952 W IRVING PARK RD, SUITE 300, CHICAGO, IL 60641-2640
(773) 942-6141
(847) 672-4799
Mailing address
4952 W IRVING PARK RD, SUITE 300, CHICAGO, IL 60641-2640
(773) 942-6141
(847) 672-4799
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.473317
IL
246ZC0007X
Surgical Assistant
238.000480
IL
363LF0000X
Family Nurse Practitioner
Primary
209.022777
IL
Other
Enumeration date
01/17/2016
Last updated
01/29/2021
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