Organization
BASSELL NURSE PRACTITIONER SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE BASSELL (OWNER)
(312) 226-0472
Entity
Organization
Contact information
Practice address
5061 N PULASKI RD, CHICAGO, IL 60630-2706
(773) 604-4217
Mailing address
1070 W 15TH ST, CHICAGO, IL 60608-1869
(312) 226-0472
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
309.008041
IL
Other
Enumeration date
04/13/2015
Last updated
04/16/2015
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