Individual
MS. IYEOKAN EMMANUELA ATIVIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
2050 NELSON RD, NEW LENOX, IL 60451-8537
(815) 463-5281
Mailing address
3001 S KING DR APT 1801, CHICAGO, IL 60616-3330
(773) 372-0827
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209022852
IL
Other
Enumeration date
03/05/2021
Last updated
03/05/2021
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