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Individual

MR. HOMERO VASQUEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
676 N SAINT CLAIR ST STE 1200, CHICAGO, IL 60611-3068
(312) 695-8182
(312) 695-4303
Mailing address
676 N SAINT CLAIR ST STE 1200, CHICAGO, IL 60611-3068
(312) 695-8182
(312) 695-4303

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085003060
IL
363AS0400X
Surgical Physician Assistant
085003060
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
085003060
LICENSE NUMBER
IL
01
P01471340
RAILROAD MEDICARE
IL
Enumeration date
10/31/2007
Last updated
04/07/2026
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