# MENS HEALTH LASALLE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548514482
- **Authorized official:** NIKKI MIGLORE (OWNER)
- **Authorized official phone:** (480) 229-1986

## Contact information

- **Practice address:** 10 S. LASALLE, SUITE 1130, CHICAGO, IL 60603
- **Practice address phone:** (480) 229-1986
- **Mailing address:** 7611 PRESLAR CT, WINDERMERE, FL 34786-5321

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LA2200X | Adult Health Nurse Practitioner | 209008745 | IL | Yes |

## Other

- **Enumeration date:** 10/30/2012
- **Last updated:** 10/30/2012