Individual
DR. CHARMAINE M HENNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
6322 N CICERO AVE, CHICAGO, IL 60646-4422
(773) 736-8088
Mailing address
4653 N PLAINFIELD AVE, NORRIDGE, IL 60706-4336
(708) 452-7449
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-116385
IL
Other
Enumeration date
04/24/2007
Last updated
07/08/2007
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