| NPI | 1164392239 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDRA CHRISTINE WEGENER Administrator 630-400-9796 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Additional Taxonomies | 363LC1500X Nurse Practitioner, Community Health |
| Enumeration Date | 2025-11-05 |
| Last Update Date | 2025-11-05 |