Rose Of Sharon Mc LLC
Nurse Practitioner, Family in Roselle, IL. Organization (NPI-2).
NPI number1164041372
StatusActive
Last updated in NPPESApr 9, 2020
Details
- NPI
- 1164041372
- Entity type
- Organization (NPI-2)
- Legal business name
- Rose Of Sharon Mc LLC
- Organization subpart
- No
- Enumeration date
- Apr 9, 2020
- Certification date
- Apr 9, 2020
- Last updated
- Apr 9, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | – | – | Yes |
Practice location
1085 Flamingo DrRoselle, IL 60172-4731
Phone 847-877-8549
Mailing address
1085 Flamingo DrRoselle, IL 60172-4731
Phone 847-877-8549
Authorized official
Reena Blesson
Owner
8478778549
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