Individual
HAROLD INOCENCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
8644 BALLARD DR, TINLEY PARK, IL 60487-3097
(773) 517-6778
Mailing address
8644 BALLARD DR, TINLEY PARK, IL 60487-3097
(773) 517-6778
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209.016737
IL
Other
Enumeration date
11/14/2019
Last updated
11/14/2019
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