SAMANTHA JERUSAL

CHICAGO, IL
NPI1013610971
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LP0200X Nurse Practitioner, Pediatrics
(Licence: IL  209.028195)
Additional Taxonomies163WP0200X Registered Nurse, Pediatrics
(Licence: OH  501051)
Enumeration Date2023-03-22
Last Update Date2023-09-05
Business Address
SAMANTHA JERUSAL
2418 W DIVISION ST
CHICAGO, IL 60622-2940
Phone number: 312-666-3494
Mailing Address
SAMANTHA JERUSAL
2418 W DIVISION ST
CHICAGO, IL 60622-2940
Phone number: 312-666-3494