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1760596282
DEIDRA R. FONTANA
CHICAGO, IL
NPI
1760596282
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: IL 209004723)
Enumeration Date
2006-08-19
Last Update Date
2007-07-08
Business Address
-- DEIDRA R. FONTANA
1740 W TAYLOR ST
CHICAGO, IL 60612-7232
Phone number: 866-600-2273
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Mailing Address
-- DEIDRA R. FONTANA
809 S MARSHFIELD AVE 9TH FLOOR (M/C 732)
CHICAGO, IL 60612-4305
Phone number: 312-996-7699
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