Organization
JESSE BROWN VA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHIRLEY ANN CAMPBELL RN (AMBULATORY CARE NURSE)
(312) 569-7718
Entity
Organization
Contact information
Practice address
820 S DAMEN AVE, CHICAGO, IL 60612-3728
(312) 569-7718
Mailing address
16908 INGLESIDE AVE, SOUTH HOLLAND, IL 60473-3063
(708) 567-5045
Taxonomy
Speciality
Code
Description
License number
State
281P00000X
Chronic Disease Hospital
Primary
041244811
IL
Other
Enumeration date
09/15/2006
Last updated
06/19/2008
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