Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | 209019306 | IL |
NPI | 1043558265 |
---|---|
Provider Name | Kathryn E Vela |
First Address | Hinsdale, IL 60521-3638 |
Second Address | Hinsdale, IL 60521-3638 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2013 |
Last Update Date | 24/07/2019 |