Individual
MS. THERESA L GORMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10829 S WESTERN AVE, SUITE B, CHICAGO, IL 60643-3229
(773) 779-8200
Mailing address
1021 FRAN LIN PKWY, MUNSTER, IN 46321-3504
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.296842
IL
163WC0200X
Critical Care Medicine Registered Nurse
Primary
041.296842
IL
Other
Enumeration date
06/06/2013
Last updated
06/11/2013
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