Individual
OMONZUA MABEL EROMOSELE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
3344 W 85TH PL, CHICAGO, IL 60652-3759
(773) 757-3879
Mailing address
3344 W 85TH PL, CHICAGO, IL 60652-3759
(773) 757-3879
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209025848
IL
Other
Enumeration date
10/11/2022
Last updated
10/11/2022
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