Individual
SKYLER G VASQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
405 S MAIN ST, BELLE RIVE, IL 62810-1228
(618) 316-1626
(618) 756-2566
Mailing address
203 W 7TH ST, BELLE RIVE, IL 62810-1252
(618) 214-2241
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3747A0650X
VA
IL
Enumeration date
06/01/2020
Last updated
06/01/2020
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