Individual
MARQUITA DENISE PORCHE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
16750 80TH AVE STE D, TINLEY PARK, IL 60477-3174
(773) 368-5619
Mailing address
16750 80TH AVE STE D, TINLEY PARK, IL 60477-3174
(773) 368-5619
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041372719
IL
363L00000X
Nurse Practitioner
Primary
209027519
IL
363LF0000X
Family Nurse Practitioner
209027519
IL
Other
Enumeration date
06/15/2023
Last updated
01/10/2024
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