Individual
MS. CRISTINA HERICO ROY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3936 N MILWAUKEE AVE, CHICAGO, IL 60641-2703
(773) 736-6125
(773) 736-9629
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209-015547
IL
363LP2300X
Primary Care Nurse Practitioner
209.015547
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05
—
IL
Enumeration date
06/21/2017
Last updated
04/21/2023
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