Individual
MARI DOLORES MERLOS VACA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
INTERN
Contact information
Practice address
5341 W CERMAK RD, CICERO, IL 60804-2892
(708) 656-6430
(708) 656-6591
Mailing address
3919 W 31ST ST, 5341 W CERMAK RD, CICERO, IL 60804-2817
(708) 656-6430
(708) 656-6591
Taxonomy
Speciality
Code
Description
License number
State
171R00000X
Interpreter
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
IL
Other
Enumeration date
12/11/2007
Last updated
06/09/2021
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