| NPI | 1609691740 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORENA NAVARRETE Credentialing Specialist 773-470-6932 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2024-11-21 |
| Last Update Date | 2025-10-06 |