Healthcare Provider Details

I. General information

NPI: 1134037575
Provider Name (Legal Business Name): VICENTE EMILIO ABUNASSAR SANCHEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

779 W ADAMS ST
CHICAGO IL
60661-3509
US

IV. Provider business mailing address

7511 N DAMEN AVE APT DG
CHICAGO IL
60645-2149
US

V. Phone/Fax

Practice location:
  • Phone: 773-234-2938
  • Fax:
Mailing address:
  • Phone: 312-538-9437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209.036495
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: