Individual
MRS. PHYLLIS VERONICA BURGESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APN MSN
Contact information
Practice address
1901 W HARRISON ST, CHICAGO, IL 60612-3714
(312) 864-4263
Mailing address
9700 S CLAREMONT AVE, CHICAGO, IL 60643-1717
(773) 233-2509
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041162850
IL
163WN0002X
Neonatal Intensive Care Registered Nurse
041-162850
IL
363LN0000X
Neonatal Nurse Practitioner
Primary
209001006
IL
364SN0000X
Neonatal Clinical Nurse Specialist
209001005
IL
Other
Enumeration date
05/21/2007
Last updated
07/14/2020
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