Individual
MRS. ELLEN DEKOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
1S072 LUTHER AVE, LOMBARD, IL 60148-4164
(630) 247-8877
Mailing address
11750 WINDING TRAILS DR, WILLOW SPRINGS, IL 60480-1191
(630) 432-9830
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209.019486
IL
Other
Enumeration date
03/02/2020
Last updated
03/02/2020
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