| NPI | 1548143191 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EBONY P BELLE-JOHNSON Advanced Practice Nurse Practitione 708-250-8799 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2025-07-30 |
| Last Update Date | 2025-07-30 |