TAKALA B FOMOND

EVANSTON, IL
NPI1215685565
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy164W00000X Licensed Practical Nurse
(Licence: IL  043.117753)
Enumeration Date2022-03-15
Last Update Date2023-11-02
Business Address
Miss TAKALA B FOMOND LPN
2916 CENTRAL ST # 2
EVANSTON, IL 60201-1212
Phone number: 224-420-6894
Mailing Address
Miss TAKALA B FOMOND LPN
2916 CENTRAL ST # 2A
EVANSTON, IL 60201-1212
Phone number: 224-420-6894
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