Provider Demographics
NPI:1619318003
Name:GATES, VALERIA (APN, FNP-BC)
Entity type:Individual
Prefix:MS
First Name:VALERIA
Middle Name:
Last Name:GATES
Suffix:
Gender:F
Credentials:APN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13450 S KEDZIE AVE
Mailing Address - Street 2:
Mailing Address - City:ROBBINS
Mailing Address - State:IL
Mailing Address - Zip Code:60472-1639
Mailing Address - Country:US
Mailing Address - Phone:708-293-8100
Mailing Address - Fax:
Practice Address - Street 1:3004 HARBORSIDE CT
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60586-1720
Practice Address - Country:US
Practice Address - Phone:708-638-4255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-13
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209010411363LF0000X
IL041312911163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse