Individual
JACLYN MARIEV MCPHEETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
17960 HALSTED ST, HOMEWOOD, IL 60430-2014
(708) 923-0911
Mailing address
17960 HALSTED ST, HOMEWOOD, IL 60430-2014
(708) 922-0911
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209021471
IL
Other
Enumeration date
09/08/2020
Last updated
09/08/2020
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