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Organization
MENS HEALTH LASALLE LLC
Active
Organization
MENS HEALTH LASALLE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NIKKI MIGLORE (OWNER)
(480) 229-1986
Entity
Organization
Contact information
Practice address
10 S. LASALLE, SUITE 1130, CHICAGO, IL 60603
(480) 229-1986
Mailing address
7611 PRESLAR CT, WINDERMERE, FL 34786-5321
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
209008745
IL
Other
Enumeration date
10/30/2012
Last updated
10/30/2012
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