Provider Demographics
NPI:1275081572
Name:VALADEZ, VERONICA (APN)
Entity Type:Individual
Prefix:MRS
First Name:VERONICA
Middle Name:
Last Name:VALADEZ
Suffix:
Gender:F
Credentials:APN
Other - Prefix:MRS
Other - First Name:VERONICA
Other - Middle Name:
Other - Last Name:VALADEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APN
Mailing Address - Street 1:3223 W 63RD ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60629-3333
Mailing Address - Country:US
Mailing Address - Phone:708-244-6133
Mailing Address - Fax:
Practice Address - Street 1:6525 26TH PL
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:IL
Practice Address - Zip Code:60402-4701
Practice Address - Country:US
Practice Address - Phone:708-244-6133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-14
Last Update Date:2017-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209013416363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily