Individual
MARIA MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
256 STONEGATE RD, TROUT VALLEY, IL 60013-2524
(815) 529-5933
Mailing address
256 STONEGATE RD, TROUT VALLEY, IL 60013-2524
(815) 529-5933
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043082841
IL
Other
Enumeration date
02/20/2024
Last updated
02/20/2024
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