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Individual

MS. WILMA MAXCINE HARRIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
11003 S HOMEWOOD AVE, CHICAGO, IL 60643-3439
(773) 779-8609
Mailing address
11003 S HOMEWOOD AVE, CHICAGO, IL 60643-3439

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043.064539
IL

Other

Enumeration date
09/12/2016
Last updated
09/12/2016
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