Individual
NAMYR HERNANDEZ LARTIGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3600 W FULLERTON AVE, CHICAGO, IL 60647-2319
(773) 782-2800
Mailing address
3600 W FULLERTON AVE, CHICAGO, IL 60647-2319
(773) 782-2800
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.010563
IL
363AM0700X
Medical Physician Assistant
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/08/2022
Last updated
08/10/2024
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