Healthcare Provider Details

I. General information

NPI: 1851232771
Provider Name (Legal Business Name): MARTINA ANTONELLA ZAPATA VACA M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2026
Last Update Date: 04/03/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 SOUTH WOOD STREET (MC675) UI HEALTH, GRADUATE MEDICAL EDUCATION OFFICE, SUITE 100
CHICAGO IL
60612
US

IV. Provider business mailing address

820 SOUTH WOOD STREET (MC675) UI HEALTH, GRADUATE MEDICAL EDUCATION OFFICE, SUITE 100
CHICAGO IL
60612
US

V. Phone/Fax

Practice location:
  • Phone: 312-996-2933
  • Fax:
Mailing address:
  • Phone: 312-996-2933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: