NPI | 1720968415 |
---|---|
Entity Type | Organization |
Authorized Contact | TIKITA MAHAN Owner 708-769-4062 |
Organization Subpart ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health |
Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health |
Enumeration Date | 2025-09-04 |
Last Update Date | 2025-09-04 |