Individual
TERESA DEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
585 TOLLGATE RD STE E, ELGIN, IL 60123-9323
(847) 462-6099
Mailing address
585 TOLLGATE RD STE E, ELGIN, IL 60123-9323
(847) 462-6099
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043.104880
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
043.104880
PRACTICAL NURSE
IL
Enumeration date
11/17/2016
Last updated
11/17/2016
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