Registry details
Type
Individual
Primary specialty
Nurse Practitioner
Enumerated
Aug 4, 2006
License(s)
209-000872 (IL)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 3240 AILSWORTH CT | Darien, IL 60561-1601 | 312-864-5223 |
| LOCATION | 1901 W HARRISON ST | Chicago, IL 60612-3714 | 312-864-6000 |
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