Individual
MS. DAISY VAZQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN, CPNP
Contact information
Practice address
966 W 21ST ST, CHICAGO, IL 60608-4511
(773) 254-1400
Mailing address
966 W 21ST ST, CHICAGO, IL 60608-4511
(773) 254-1400
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
209009912
IL
Other
Enumeration date
03/04/2013
Last updated
03/04/2013
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