Individual
JUAN ELIAS VASQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AUD
Contact information
Practice address
920 W CULLOM AVE PH UNIT, CHICAGO, IL 60613-1632
(909) 992-9660
Mailing address
920 W CULLOM AVE PH UNIT, CHICAGO, IL 60613-1632
(909) 992-9660
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
147.001756
IL
Other
Enumeration date
01/22/2020
Last updated
01/22/2020
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