| NPI | 1437864162 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEISHA NICOLE HOUSE Nurse Practitioner 773-655-0899 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2023-01-17 |
| Last Update Date | 2023-10-09 |