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Individual

LINDA GRACE PARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
733 ASCOT CT, HOFFMAN ESTATES, IL 60194-2769
(847) 519-0830
Mailing address
915 CENTER ST, ELGIN, IL 60120-2106
(847) 931-4200

Taxonomy

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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
K21789
IL
Enumeration date
07/11/2006
Last updated
07/08/2007
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