Individual
SAUDAH NANTAMBI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
310 ARIZONA BLVD, HOFFMAN ESTATES, IL 60169-1923
(224) 595-9890
Mailing address
6 WALDEN TRL, STREAMWOOD, IL 60107-1680
(224) 428-4047
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043.130429
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
53578090894N
STATE OF ILLINOIS
IL
Enumeration date
09/20/2021
Last updated
09/20/2021
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