SHANNA MARIE WIDERA

CHICAGO, IL
NPI1790710531
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LP0200X Nurse Practitioner, Pediatrics
(Licence: IL  209004579)
Enumeration Date2006-07-11
Last Update Date2019-11-21
Business Address
Ms. SHANNA MARIE WIDERA RN, APN
225 E CHICAGO AVE BOX #59
CHICAGO, IL 60611-2991
Phone number: 312-227-6778
Mailing Address
Ms. SHANNA MARIE WIDERA RN, APN
1221 N DEARBORN ST APT 603N
CHICAGO, IL 60610-8375
Phone number: 773-398-7880
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