Individual
MISS TAKALA B FOMOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
9150 CRAWFORD AVE # L1, SKOKIE, IL 60076-1700
(224) 420-6894
Mailing address
2916 CENTRAL ST # 2A, EVANSTON, IL 60201-1212
(224) 420-6894
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041.595283
IL
Other
Enumeration date
03/15/2022
Last updated
12/09/2025
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