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1760030498
TANIYAMOL JOSEPH
WAUKEGAN, IL
NPI
1760030498
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: IL 209019253)
Enumeration Date
2019-08-27
Last Update Date
2021-04-26
Business Address
MISS TANIYAMOL JOSEPH NP
2504 WASHINGTON ST STE 102
WAUKEGAN, IL 60085-4960
Phone number: 847-623-7590
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Mailing Address
MISS TANIYAMOL JOSEPH NP
8995 KENNEDY DR APT 1F
DES PLAINES, IL 60016-5400
Phone number: 224-616-0485
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