Individual
SAMANTHA LARUE GREENWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
126 DELAWARE DR, BOLINGBROOK, IL 60440-2368
(630) 991-8556
Mailing address
126 DELAWARE DR, BOLINGBROOK, IL 60440-2368
(630) 991-8556
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041430338
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
144316
IL
Other
Enumeration date
09/13/2021
Last updated
11/07/2023
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