Individual
MRS. JENNETT KYEN ATANGA II
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
820 S DAMEN AVE, CHICAGO, IL 60612
(630) 596-7113
Mailing address
820 S DAMEN AVE, CHICAGO, IL 60612-3728
(630) 596-7113
(312) 226-6177
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
209018017
IL
363LG0600X
Gerontology Nurse Practitioner
Primary
209018017
IL
Other
Enumeration date
08/10/2018
Last updated
09/07/2018
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