Individual
KERRI DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
4061 W 95TH ST, OAK LAWN, IL 60453-2611
(888) 693-6437
Mailing address
PO BOX 713260, CHICAGO, IL 60677-1260
(630) 469-9200
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041431669
IL
363L00000X
Nurse Practitioner
Primary
209.023877
IL
Other
Enumeration date
08/09/2021
Last updated
06/30/2023
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