TERESA WYATT KODIAK

CHICAGO, IL
NPI1902236912
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: IL  219010786)
Enumeration Date2013-11-13
Last Update Date2017-03-24
Business Address
-- TERESA WYATT KODIAK APN-CNP, FNP-C
611 W ROOSEVELT RD
CHICAGO, IL 60607-4911
Phone number: 773-570-3382
Mailing Address
-- TERESA WYATT KODIAK APN-CNP, FNP-C
611 W ROOSEVELT RD
CHICAGO, IL 60607-4911
Phone number: 773-570-3382