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General NPI Number Information
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NPI Number | 1477061620
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Entity Type | Individual
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Provider Name | YESENIA RAITHEL VARGAS CNM, FPA
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Gender | Female
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Dates
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Enumeration Date | 01/22/2018
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Last Update Date | 10/07/2025
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Provider Practice Location Address
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Address Line | 3059 W 26TH ST
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City | CHICAGO
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State | IL
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Zip | 60623-4131
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Country | US
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Telephone | 773-584-6200
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Fax |
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Provider Business Mailing Address
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Address Line | 3059 W 26TH ST
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City | CHICAGO
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State | IL
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Zip | 60623-4131
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Country | US
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Telephone | 773-584-6200
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | 277.004592
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LX0001X
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Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
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License Number | 209.016919
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License Number State | IL
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