Individual
ALOHA PENAFLOR LEBLANC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5215 N CALIFORNIA AVE STE F101, CHICAGO, IL 60625-0035
(773) 561-5809
Mailing address
2579 W MONTROSE AVE APT 3S, CHICAGO, IL 60618-1518
(312) 371-2816
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209016903
IL
363LP2300X
Primary Care Nurse Practitioner
209016903
IL
Other
Enumeration date
12/28/2017
Last updated
08/13/2020
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