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Individual

ETHAN JOSE EDER SANCHEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MSN, RN, FNP-BC

Contact information

Practice address
1203 W AUGUSTA BLVD STE 1, CHICAGO, IL 60642-4327
(773) 248-2255
(773) 304-4143
Mailing address
735 CHICAGO AVE UNIT 243, EVANSTON, IL 60202-2378
(409) 225-4321

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
10068
MN
363LF0000X
Family Nurse Practitioner
Primary
209027034
IL

Other

Enumeration date
04/04/2023
Last updated
08/11/2023
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