Individual
AUDREY STANDAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
8420 W BRYN MAWR AVE, SUITE 300, CHICAGO, IL 60631-3479
(773) 355-5300
Mailing address
5620 JAY DR, CRYSTAL LAKE, IL 60014-4644
(815) 236-3015
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041231620
IL
Other
Enumeration date
08/25/2011
Last updated
08/25/2011
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