Individual
ERIC HAVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
18517 LEXINGTON AVE, HOMEWOOD, IL 60430-3617
(708) 217-4761
Mailing address
18517 LEXINGTON AVE, HOMEWOOD, IL 60430-3617
(708) 217-4761
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041306313
IL
163WR0006X
Registered Nurse First Assistant
Primary
041306313
IL
163WX0800X
Orthopedic Registered Nurse
041306313
IL
Other
Enumeration date
08/07/2023
Last updated
08/07/2023
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