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1205947983
MARITTA A PENEGOR
DYER, IN
NPI
1205947983
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: IN 70000040A)
Enumeration Date
2006-08-31
Last Update Date
2007-09-27
Business Address
MARITTA A PENEGOR NP-BC
24 JOLIET ST SUITE 401
DYER, IN 46311-1705
Phone number: 219-865-0893
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Mailing Address
MARITTA A PENEGOR NP-BC
3615 PARK DR SUITE 203
OLYMPIA FIELDS, IL 60461-1186
Phone number: 708-748-9800
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