Registry details
Type
Organization
Primary specialty
Nurse Practitioner, Family
Enumerated
May 15, 2023
License(s)
—
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 2933 198TH ST | Lynwood, IL 60411-1478 | 872-316-1959 |
| MAILING | 2933 198TH ST | Lynwood, IL 60411-1478 | 872-316-1959 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.