Individual
MR. ANGEL ROMULO FUENTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5461 W LAKE ST, CHICAGO, IL 60644-2343
(954) 639-2757
Mailing address
5461 W LAKE ST, CHICAGO, IL 60644-2343
(954) 639-2757
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.012369
IL
363A00000X
Physician Assistant
1231186
—
Other
Enumeration date
03/09/2026
Last updated
08/12/2026
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