AZALEA VICENTENO (NPI# 1386187912) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386187912 |
| Entity Type | Individual |
| Full Name | AZALEA VICENTENO |
| Practice Address |
3600 W Fullerton Ave Chicago IL 60647-2319 |
| Mailing Address |
1464 S Michigan Ave 1402 Chicago IL 60605-3711 |
| Practice Telephone | 7737822800 |
| Mailing Telephone | 3125608368 |
| Enumeration Date | 2016-11-30 |
| Last Update Date | 2020-09-29 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209015196 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3600 W FULLERTON AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60647-2319 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760485379 | Jeanne S Findlay | Nurse Practitioner | 3600 W Fullerton Ave, Chicago, IL 60647-2319 | 2005-05-27 |
| 1497379630 | Nora Vela | Dental Hygienist | 3600 W Fullerton Ave, Chicago, IL 60647-2319 | 2020-06-03 |
| 1598398034 | Emmanuel Barron | Physician Assistant | 3600 W Fullerton Ave, Chicago, IL 60647-2319 | 2020-02-12 |
| 1255970141 | Joann Reyes | Nurse Practitioner | 3600 W Fullerton Ave, Chicago, IL 60647-2319 | 2019-12-25 |
| 1962049452 | Susely Guevara | Nurse Practitioner | 3600 W Fullerton Ave, Chicago, IL 60647-2319 | 2019-12-04 |
| 1689142051 | Laboratory Corporation of America | Clinical Medical Laboratory | 3600 W Fullerton Ave, Chicago, IL 60647-2319 | 2018-11-05 |
| 1922573112 | Infant Welfare Society of Chicago | Case Management | 3600 W Fullerton Ave, Chicago, IL 60647-2319 | 2018-10-04 |
| 1619476116 | Xiomara Nieto | Nurse Practitioner | 3600 W Fullerton Ave, Chicago, IL 60647-2319 | 2018-02-09 |
| 1063930907 | Jessica Espinosa | Nurse Practitioner | 3600 W Fullerton Ave, Chicago, IL 60647 | 2017-08-30 |
| 1851829287 | Marco Antonio Oviedo | Counselor | 3600 W Fullerton Ave, Chicago, IL 60647-2319 | 2017-05-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164035879 | Scott Spine and Health LLC | Chiropractor | 2560 W. Armitage Ave, Unit C2, Chicago, IL 60647 | 2020-08-24 |
| 1003424458 | Emily Gleesing | Physical Therapist | 1923 N Western Ave, Chicago, IL 60647 | 2020-07-21 |
| 1699301358 | Marcella Guzman P.C. | Dentist | 3236 W. Fullerton Ave., Chicago, IL 60647 | 2020-03-13 |
| 1740772342 | Envision Unlimited | Case Management | 2646 N Washtenaw Ave # 3n, Chicago, IL 60647 | 2018-05-31 |
| 1992297535 | Envision Unlimited | Case Management | 2646 N Washtenaw Ave # 2n, Chicago, IL 60647 | 2018-05-30 |
| 1942704580 | Team Rehabilitation Il15, LLC | Physical Therapist | 1923 N Western Avenue, Chicago, IL 60647 | 2018-03-20 |
| 1023517331 | Chicago Medical Healthcare Group, S.c. | Family Medicine | 3648 W Armitage Avenue, Chicago, IL 60647 | 2018-02-02 |
| 1023537693 | Erin Frommeyer | Physician Assistant | 2228 W Dickens Avenue, Chicago, IL 60647 | 2017-09-15 |
| 1457872475 | Stefanie Paola Maurtua | Behavioral Analyst | 2448 West Bloomingdale Ave., Apt 2e, Chicago, IL 60647 | 2017-06-29 |
| 1700322922 | Lumen Optical Illinois 4, LLC | Optometrist | 2420 N Elston, Bucktown, IL 60647 | 2017-01-11 |
| Find all providers in zip 60647 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932700911 | Laura Ivette Portillo | Nurse Practitioner | 2727 N Marmora Ave, Chicago, IL 60639-1219 | 2020-11-05 |
| 1265033385 | Carolle M Derradji | Nurse Practitioner | 3256 W Potomac Ave, Chicago, IL 60651-2411 | 2020-11-04 |
| 1104427293 | Katie Michelle O'halloran | Nurse Practitioner | 5841 S Maryland Ave # E500, Chicago, IL 60637-1443 | 2020-11-04 |
| 1578163515 | Deanna Bassette | Nurse Practitioner | 243 E 31st St Apt 401, Chicago, IL 60616-5212 | 2020-10-29 |
| 1891395745 | Vrunda Shah Patel | Nurse Practitioner | 933 W Van Buren St Apt 502, Chicago, IL 60607-3583 | 2020-10-29 |
| 1881291706 | Rita Elue | Nurse Practitioner | 6241 N Winthrop Ave Apt 307, Chicago, IL 60660-2071 | 2020-10-04 |
| 1558976514 | Janice Nicole Kinney | Nurse Practitioner | 10127 S Harding Ave, Chicago, IL 60655-3748 | 2020-09-15 |
| 1881209278 | Monique Graves | Nurse Practitioner | 4912 W Adams St Apt 2, Chicago, IL 60644-4445 | 2020-09-11 |
| 1194339721 | Maureen Iyesogie Diji | Nurse Practitioner | 4658 S Ellis Ave, Chicago, IL 60653-3625 | 2020-09-01 |
| 1669085395 | Emily Calderon | Nurse Practitioner | 5556 N Sheridan Rd Apt 506, Chicago, IL 60640-1677 | 2020-08-24 |
| Find all providers in CHICAGO | ||||
Please comment or provide details below to improve the information on AZALEA VICENTENO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.