Healthcare Provider Details

I. General information

NPI: 1427988393
Provider Name (Legal Business Name): SANDY VILLANUEVA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 N NORTHWEST HWY STE 207
PARK RIDGE IL
60068-3292
US

IV. Provider business mailing address

116 S NORTHWEST HWY # 192
BARRINGTON IL
60010-4608
US

V. Phone/Fax

Practice location:
  • Phone: 331-240-0044
  • Fax:
Mailing address:
  • Phone: 331-240-0044
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: