LARISA G BASA

PARK RIDGE, IL
NPI1336884493
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: IL  209.024855)
Enumeration Date2022-05-03
Last Update Date2022-12-22
Business Address
LARISA G BASA
1675 W DEMPSTER ST
PARK RIDGE, IL 60068-1110
Phone number: 847-723-9470
Mailing Address
LARISA G BASA
29373 NETWORK PL
CHICAGO, IL 60673-2926
Phone number: 847-390-5900
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