Individual
GRACIELA CHAIDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5000 S 5TH AVE, HINES, IL 60141-3030
(708) 202-8387
(708) 202-2163
Mailing address
5000 S 5TH AVE, HINES, IL 60141-3030
(708) 202-8387
(708) 202-2163
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041378041
IL
363L00000X
Nurse Practitioner
Primary
209.012260
IL
Other
Enumeration date
03/09/2015
Last updated
03/09/2015
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