Individual
MARY C LOGALBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
2124 OGDEN AVE STE 301, AURORA, IL 60504-7542
(630) 392-3431
Mailing address
748 VERSAILLES PKWY, OSWEGO, IL 60543-6019
(630) 392-3431
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209.011822
IL
Other
Enumeration date
10/02/2014
Last updated
12/21/2023
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