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Individual

EBONI VAUGHN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
63 W 87TH ST, NAPERVILLE, IL 60565
(630) 778-7645
Mailing address
5309 IMPERIAL DR, RICHTON PARK, IL 60471-1557
(708) 297-7325

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209017491
IL

Other

Enumeration date
04/20/2018
Last updated
06/19/2018
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