STACEY JAIMES-HERRERA

CHICAGO, IL
NPI1225617764
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: IL  125077523)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2021-04-02
Last Update Date2021-08-12
Business Address
STACEY JAIMES-HERRERA
2750 W NORTH AVE
CHICAGO, IL 60647-5247
Phone number: 312-666-3493
Mailing Address
STACEY JAIMES-HERRERA
2750 W NORTH AVE
CHICAGO, IL 60647-5247
Phone number: 312-666-3493