Individual
QUATANYA SEALS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9931 S CRANDON AVE, CHICAGO, IL 60617-5243
(773) 892-5566
Mailing address
9931 S CRANDON AVE, CHICAGO, IL 60617-5243
(773) 892-5566
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041424259
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041424259
ILLINOIS NURSING BOARD
IL
Enumeration date
02/21/2019
Last updated
02/21/2019
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