Individual
SANDRA VEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-9000
Mailing address
PO BOX 35380, LAS VEGAS, NV 89133-5380
(702) 820-3581
(702) 804-3783
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036094379
IL
207V00000X
Obstetrics & Gynecology Physician
12980
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760454979
—
NV
01
—
V56504
MEDICARE
NV
Enumeration date
02/02/2006
Last updated
10/04/2022
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