Individual
SHIRLEY LOCKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14516 THOMAS JEFFERSON DR, PLAINFIELD, IL 60544-4423
(708) 955-1425
Mailing address
140 N ASHLAND AVE, CHICAGO, IL 60607-1802
(312) 850-0050
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
041404657
IL
Other
Enumeration date
01/02/2020
Last updated
01/02/2020
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