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General NPI Number Information
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NPI Number | 1881556256
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Entity Type | Individual
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Provider Name | JAQUANDA MICHELLE VILLEGAS
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Gender | Female
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Dates
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Enumeration Date | 11/24/2025
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Last Update Date | 11/24/2025
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Provider Practice Location Address
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Address Line | 4755 N SHERIDAN RD
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City | CHICAGO
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State | IL
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Zip | 60640-5051
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Country | US
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Telephone | 773-550-4229
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Fax |
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Provider Business Mailing Address
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Address Line | 6524 S SAINT LAWRENCE AVE
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City | CHICAGO
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State | IL
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Zip | 60637-3331
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Country | US
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Telephone | 773-550-3849
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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 | 261QB0400X
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Taxonomy Name | Birthing Clinic/Center
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License Number | S436-4337-4776
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License Number State | IL
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