Individual
MARY JANE WELCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2150 W HARRISON ST, CHICAGO, IL 60612-3706
(312) 942-3112
(312) 942-2874
Mailing address
2150 W HARRISON ST, CHICAGO, IL 60612-3706
(312) 942-3112
(312) 942-2874
Taxonomy
Speciality
Code
Description
License number
State
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
Primary
209-002406
IL
Other
Enumeration date
07/11/2011
Last updated
07/11/2011
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