Individual
MRS. KATLYN POUPORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
3 ERIE CT, OAK PARK, IL 60302-2519
(708) 763-6747
Mailing address
6110 N OTTAWA AVE, CHICAGO, IL 60631-3813
(773) 391-7381
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
04138163
IL
363L00000X
Nurse Practitioner
Primary
209013226
IL
363LF0000X
Family Nurse Practitioner
209013226
IL
Other
Enumeration date
07/19/2012
Last updated
12/08/2017
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