Individual
NICOLE VILLANUEVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4201 W MEDICAL CENTER DR, MCHENRY, IL 60050-8409
(815) 344-5000
Mailing address
4201 MEDICAL CENTER DR, MCHENRY, IL 60050
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085005863
IL
Other
Enumeration date
09/21/2016
Last updated
09/16/2020
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