Individual
BETH SHAFER VENUGOPAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
1942 DEMPSTER ST, EVANSTON, IL 60202-1016
(847) 688-1900
(847) 869-7392
Mailing address
1300 MAIN ST, EVANSTON, IL 60202-1653
(803) 413-9371
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
Primary
041260944
IL
Other
Enumeration date
04/18/2023
Last updated
04/18/2023
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