Individual
MRS. RUTHIE CELESTINE GAVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
12251 S 80TH AVE, PALOS HEIGHTS, IL 60463
(630) 257-1111
(630) 257-1115
Mailing address
12251 S 80TH AVE STE 1630, PALOS HEIGHTS, IL 60463-1256
(708) 923-5173
(708) 923-5018
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
041.322139
IL
363LF0000X
Family Nurse Practitioner
209.019276
IL
Other
Enumeration date
02/28/2019
Last updated
06/10/2019
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