Individual
SAMIYYAH EDMISTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1015 W LAWRENCE AVE FL 2, CHICAGO, IL 60640-5017
(773) 275-2586
Mailing address
1015 W LAWRENCE AVE FL 2, CHICAGO, IL 60640-5017
(773) 275-2586
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041.444621
IL
Other
Enumeration date
06/29/2020
Last updated
06/29/2020
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