NPI | 1306977970 |
---|---|
Entity Type | Organization |
Authorized Contact | CAROLINE KREISL WILSON Owner 773-600-2601 |
Organization Subpart ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IL 041256041) |
Enumeration Date | 2007-03-08 |
Last Update Date | 2010-05-06 |