Individual
PATRICIA ENGWALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
471 W TERRA COTTA AVE, CRYSTAL LAKE, IL 60014-3434
(815) 455-0550
Mailing address
471 W TERRA COTTA AVE, CRYSTAL LAKE, IL 60014-3434
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
160.003419
IL
Other
Enumeration date
03/15/2016
Last updated
03/15/2016
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