Individual
ELLEN MARIE COSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
14680 S LA GRANGE RD, ORLAND PARK, IL 60462-2510
(800) 323-8622
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209007696
IL
Other
Enumeration date
11/11/2009
Last updated
06/06/2022
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