AUDREY OETOMO

CHICAGO, IL
NPI1457789315
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LP0200X Nurse Practitioner, Pediatrics
(Licence: IL  209013763)
Enumeration Date2013-10-30
Last Update Date2022-10-24
Business Address
AUDREY OETOMO
5841 S MARYLAND AVE
CHICAGO, IL 60637-1443
Phone number: 888-824-0200
Mailing Address
AUDREY OETOMO
150 HARVESTER DR SUITE 300
BURR RIDGE, IL 60527-5919
Phone number: