Healthcare Provider Details

I. General information

NPI: 1477010031
Provider Name (Legal Business Name): CYNTHIA SALAZAR APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2019
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 E 2ND ST
SPRING VALLEY IL
61362-1517
US

IV. Provider business mailing address

415 E 2ND ST
SPRING VALLEY IL
61362-1517
US

V. Phone/Fax

Practice location:
  • Phone: 815-221-1340
  • Fax: 309-308-5095
Mailing address:
  • Phone: 815-221-1340
  • Fax: 309-308-5095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209018638
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: