Healthcare Provider Details

I. General information

NPI: 1538088745
Provider Name (Legal Business Name): SANDRA VALDEZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1520 W HARRISON ST
CHICAGO IL
60607-3106
US

IV. Provider business mailing address

8611 PATRICIA DR
LYONS IL
60534-1042
US

V. Phone/Fax

Practice location:
  • Phone: 312-563-3906
  • Fax: 312-563-3945
Mailing address:
  • Phone: 312-563-3906
  • Fax: 312-563-3945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number041433491
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: