| NPI | 1790976231 |
|---|---|
| Other Name | MARITTA A PENEGOR CFNP |
| Entity Type | Organization |
| Authorized Contact | DEBORAH J NELSON CEO 708-747-7960 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 041210941) |
| Enumeration Date | 2007-08-08 |
| Last Update Date | 2007-08-09 |