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Individual

MS. DIANA KOPERNY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
515 KELLER AVE, WAUKEGAN, IL 60085-5008
(847) 377-8700
Mailing address
3010 GRAND AVE, WAUKEGAN, IL 60085-2321
(847) 377-8122

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041231211
IL

Other

Enumeration date
06/10/2008
Last updated
06/10/2008
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