Individual provider · Type 1 NPI
Azalea Vicenteno
Family Nurse Practitioner · Chicago, IL
NPI number
1386187912
Active
Practice location
3600 W Fullerton Ave
Chicago, IL 60647-2319
Mailing address
1464 S Michigan Ave, 1402
Chicago, IL 60605-3711
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | 209015196 (IL) |
Family Nurse Practitioner: Definition to come...
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About NPI 1386187912
Azalea Vicenteno's National Provider Identifier is 1386187912, issued on Nov 30, 2016. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Chicago, IL. The record was last updated on Sep 29, 2020.