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1033531736
WANISSA FORD
CHICAGO, IL
NPI
1033531736
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: IL 209.011082)
Enumeration Date
2014-01-14
Last Update Date
2014-02-21
Business Address
-- WANISSA FORD FNP-BC
3752 W 16TH ST
CHICAGO, IL 60623-2028
Phone number: 773-762-2435
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Mailing Address
-- WANISSA FORD FNP-BC
3752 W 16TH ST
CHICAGO, IL 60623-2028
Phone number: 773-762-2435
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