Individual
MARY V FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
4440 W 95TH ST STE 1200H, OAK LAWN, IL 60453-2600
(708) 684-3133
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-9374
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
209.007928
IL
Other
Enumeration date
03/12/2010
Last updated
09/19/2022
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