Individual
ERICA DENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5841 S MARYLAND AVE, CHICAGO, IL 60637-1443
(773) 702-1000
Mailing address
1847 CANAL ST APT 2C, BLUE ISLAND, IL 60406-3554
(708) 466-9123
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
041340283
IL
363LF0000X
Family Nurse Practitioner
Primary
209023333
IL
Other
Enumeration date
06/22/2021
Last updated
06/22/2021
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