Healthcare Provider Details

I. General information

NPI: 1417781931
Provider Name (Legal Business Name): VALERIE SUZANNE BIALAS DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2024
Last Update Date: 08/27/2024
Certification Date: 08/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 W VAN BUREN ST
CHICAGO IL
60612-5500
US

IV. Provider business mailing address

814 79TH ST
DARIEN IL
60561-5102
US

V. Phone/Fax

Practice location:
  • Phone: 287-531-2563
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number209029699
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number209029699
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number209029699
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: