Individual
HOLLY RENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
2650 RIDGE AVE, EVANSTON, IL 60201-1700
(847) 570-1027
Mailing address
5841 S MARYLAND AVE, CHICAGO, IL 60637-1447
(773) 702-1000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209-004790
IL
Other
Enumeration date
08/31/2007
Last updated
07/16/2024
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