Registry details
Type
Individual
Primary specialty
Nurse Practitioner, Family
Enumerated
Jan 25, 2016
License(s)
209.013746 (IL)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 1500 S FAIRFIELD AVE | Chicago, IL 60608-1782 | 773-542-2000 |
| MAILING | 1500 S FAIRFIELD AVE | Chicago, IL 60608-1782 | 708-654-3158 |
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