Michelle Adichithara
Nurse Practitioner, Family in Maywood, IL. Individual provider (NPI-1).
NPI number1174069512
StatusActive
Last updated in NPPESJun 1, 2022
Details
- NPI
- 1174069512
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Michelle Adichithara
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 9, 2017
- Certification date
- Jun 1, 2022
- Last updated
- Jun 1, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 209015427 | IL | Yes |
Practice location
2160 S 1st AveMaywood, IL 60153-3328
Phone 708-216-9000
Mailing address
2160 S 1st AveMaywood, IL 60153-3328
Phone 708-216-9000
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