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MALLARI SOJOU PEACE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-BC

Contact information

Practice address
2045 W WASHINGTON BLVD, CHICAGO, IL 60612-2428
(312) 996-2000
Mailing address
533 E 33RD PL APT 505, CHICAGO, IL 60616-4164
(617) 763-7994

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209.008468
IL

Other

Enumeration date
11/17/2010
Last updated
11/17/2010
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