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Sully Vega
Family Nurse Practitioner in Wauconda, Illinois
NPI 1699434266

Sully Vega is a Family Nurse Practitioner based in Wauconda, IL and is specialized in Family. Sully Vega practices in Wauconda, IL. The NPI Number for Sully Vega is 1699434266 and holds a License No. 041424936 (Illinois).

The current practice location address for Sully Vega is 431 W Liberty St, Wauconda, IL and can be reached out via phone at 847-526-2151 and via fax at 847-526-2017.

Location: 431 W Liberty St, Wauconda, IL, 60084-6037
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1699434266
Provider Name
Sully Vega
Credential
Provider Entity Type
Individual
Gender
Female
Address
431 W Liberty St, Wauconda, IL, 60084-6037
Phone Number
847-526-2151
Fax Number
847-526-2017
Provider Enumeration Date
12/10/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
431 W Liberty St
City
Wauconda
State
Illinois
Zip
60084-2452
Phone Number
847-526-2151
Fax Number
847-526-2017
person
Provider Business Mailing Address Details
Address
431 W Liberty St
City
Wauconda
State
Illinois
Zip
60084-2452
Phone Number
847-526-2151
Fax Number
847-526-2017
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
209024893 (Illinois)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
041424936 (Illinois)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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