Healthcare Provider Details

I. General information

NPI: 1750240297
Provider Name (Legal Business Name): VICTORIA SALAZAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2026
Last Update Date: 01/20/2026
Certification Date: 01/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 NORTH BRAINARD ST
NAPERVILLE IL
60540
US

IV. Provider business mailing address

113 N 2ND AVE
VILLA PARK IL
60181-2318
US

V. Phone/Fax

Practice location:
  • Phone: 630-613-0867
  • Fax:
Mailing address:
  • Phone: 630-613-0867
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: