Individual
SENORA NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
901 E SIBLEY BLVD, SOUTH HOLLAND, IL 60473-1166
(773) 233-4100
(773) 233-4055
Mailing address
PO BOX 288080, CHICAGO, IL 60628-8080
(773) 233-4100
(773) 233-4055
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
036106244
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036106244
—
IL
Enumeration date
02/08/2007
Last updated
06/12/2008
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