Individual
DR. ELBA MARITZA VILLAVICENCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7000 CERMAK RD, BERWYN, IL 60402-2112
(708) 484-8090
Mailing address
PO BOX 746715, ATLANTA, GA 30374-6715
(773) 352-1515
(312) 929-0373
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036131538
IL
Other
Enumeration date
01/09/2010
Last updated
06/20/2025
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