Individual
AUDREY SIMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3333 GREEN BAY RD, NORTH CHICAGO, IL 60064-3037
(847) 578-3000
Mailing address
12567 NW WAKER DR, PORTLAND, OR 97229-8547
(503) 729-4164
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/10/2025
Last updated
03/10/2025
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