Individual
MRS. VIRGINIA BAHENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC, PMHNP-BC
Contact information
Practice address
5747 W FULLERTON AVE, CHICAGO, IL 60639-2353
(773) 413-7264
(773) 413-7013
Mailing address
5747 W FULLERTON AVE, CHICAGO, IL 60639-2353
(773) 413-7264
(773) 413-7013
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
209025213
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2023019943
IL
Other
Enumeration date
01/24/2023
Last updated
05/08/2024
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