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JUDITH MONGOUM PENE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
1305 RANDALL RD, CRYSTAL LAKE, IL 60014-8601
(815) 386-0386
Mailing address
1305 RANDALL RD, CRYSTAL LAKE, IL 60014-8601
(815) 356-0386

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209.020328
IL

Other

Enumeration date
12/13/2019
Last updated
05/31/2023
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