TARA DEDIC HENRIKSON

CHICAGO, IL
NPI1225386345
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LA2200X Nurse Practitioner, Adult Health
(Licence: IL  209.009963)
Additional Taxonomies163WX0200X Registered Nurse, Oncology
(Licence: IL  041347688)
363L00000X Nurse Practitioner
(Licence: IL  209009963)
Enumeration Date2012-08-21
Last Update Date2019-09-18
Business Address
TARA DEDIC HENRIKSON APN
250 E SUPERIOR ST STE 4-420
CHICAGO, IL 60611-2914
Phone number: 312-695-0990
Mailing Address
TARA DEDIC HENRIKSON APN
2160 SOUTH 1ST AVENUE
MAYOOWD, IL 60153
Phone number: 708-216-9000