Individual
MRS. RENETTA DENISE LINCOLN-STALLWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
11110 S HOMEWOOD AVE, #A1, CHICAGO, IL 60643-4233
(773) 425-5951
Mailing address
11110 S HOMEWOOD AVE, #A1, CHICAGO, IL 60643-4233
(773) 425-5951
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043084625
IL
Other
Enumeration date
12/07/2011
Last updated
12/07/2011
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