| NPI | 1790499663 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIRLEY REYNOLDS Family Nurse Practitioner 773-996-0242 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2023-01-05 |
| Last Update Date | 2023-01-05 |