Individual
MARY-JENNELLE GUEVARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1875 DEMPSTER ST, SUITE 180, PARK RIDGE, IL 60068-1186
(847) 897-9010
Mailing address
1875 DEMPSTER ST, SUITE 180, PARK RIDGE, IL 60068-1186
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
209009523
IL
Other
Enumeration date
05/11/2012
Last updated
02/19/2015
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