Individual
MAKENZIE ANN ALI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
901 MACARTHUR BLVD, MUNSTER, IN 46321-2901
(219) 836-1600
Mailing address
1739 MUIFIELD DR, NEW LENOX, IL 60451
(815) 386-4432
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
28277211A
IN
363L00000X
Nurse Practitioner
Primary
209026366
IL
363L00000X
Nurse Practitioner
71013157A
IN
Other
Enumeration date
09/22/2022
Last updated
02/28/2024
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