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Individual

DONNA MARIE MANGRUEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APN

Contact information

Practice address
5841 S MARYLAND AVE, CHICAGO, IL 60637-1447
(773) 702-7812
Mailing address
3208 PECAN ST, ROCKFORD, IL 61114-6061
(815) 543-7020

Taxonomy

Speciality
Code
Description
License number
State
364SA2200X
Adult Health Clinical Nurse Specialist
Primary
209.009325
IL

Other

Enumeration date
05/02/2012
Last updated
05/02/2012
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