| NPI | 1407567811 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANISHA JENEICE RAYSON-HNERY Nurse Practitioner 773-895-6866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family |
| Enumeration Date | 2022-12-06 |
| Last Update Date | 2022-12-06 |