Individual
NANCY M DOHERTY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1100 PEMBRIDGE DR, LAKE FOREST, IL 60045
(847) 604-6700
(847) 570-3426
Mailing address
3200 GRANT ST, ATTN ACCOUNTING DEPARTMENT, EVANSTON, IL 60201
(847) 492-4871
(847) 570-3426
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
IL
Other
Enumeration date
03/15/2006
Last updated
07/08/2007
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