Valencia, Mauricio

Valencia, Mauricio is an individual health care provider with primary practice located at 850 Busse Hwy , Park Ridge IL 60068-2302. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is his primary health care specialty. Valencia, Mauricio can be contacted via phone (847) 759-4770.

Contact Information

Primary practice address
850 Busse Hwy Park Ridge IL 60068-2302
Phone: (847) 759-4770
Fax: (847) 759-8824
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 10933 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 209.017085 Illinois

Profile Details

NPI number 1134636228
LBN Legal business name Valencia, Mauricio
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 10th, 2018
Last updated Dec 16th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1134636228 NPPES
Wisconsin MEDICAID 100170179

Popular Providers