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Individual

IVY-LOU VILLANUEVA IRAULA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSN, CNM, WHNP-BC

Contact information

Practice address
675 N SAINT CLAIR ST STE 14-200, CHICAGO, IL 60611-5966
(312) 695-7382
(312) 695-0014
Mailing address
675 N SAINT CLAIR ST STE 14-200, CHICAGO, IL 60611-5966
(312) 695-7382
(312) 695-0014

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209011826
IL
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
209011825
IL

Other

Enumeration date
10/01/2014
Last updated
11/08/2024
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