NPI | 1598308702 |
---|---|
Entity Type | Organization |
Authorized Contact | KARAN STAGGERS President 312-307-1295 |
Organization Subpart ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health |
363LP0200X Nurse Practitioner, Pediatrics | |
Enumeration Date | 2019-10-21 |
Last Update Date | 2019-10-21 |