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1255880969
MYRTISE SHEPARD
CHICAGO, IL
NPI
1255880969
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: IL 043-028179)
Enumeration Date
2016-09-23
Last Update Date
2016-09-23
Business Address
-- MYRTISE SHEPARD
12324 S UNION UNION AVE
CHICAGO, IL 60628-6433
Phone number: 773-317-2943
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Mailing Address
-- MYRTISE SHEPARD
12324 S UNION UNION AVE
CHICAGO, IL 60628-6433
Phone number: 773-317-2943
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