VENUS LIEZL BASNILLO- SAN DIEGO

CHICAGO, IL
NPI1265971204
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LA2200X Nurse Practitioner, Adult Health
(Licence: IL  209015653)
Enumeration Date2017-02-22
Last Update Date2017-02-22
Business Address
-- VENUS LIEZL BASNILLO- SAN DIEGO APN
1628 N BELL AVE APT 1
CHICAGO, IL 60647-5289
Phone number: 773-600-1309
Mailing Address
-- VENUS LIEZL BASNILLO- SAN DIEGO APN
1628 N BELL AVE APT. 1
CHICAGO, IL 60647-5289
Phone number: 773-600-1309
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