Individual
JULIE L VIVANCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
2003 W FULTON ST, CHICAGO, IL 60612-2345
(312) 243-2223
(312) 243-2227
Mailing address
2003 W FULTON ST, CHICAGO, IL 60612-2345
(312) 243-2223
(312) 243-2227
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209029725
IL
Other
Enumeration date
10/09/2018
Last updated
10/06/2025
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