Individual
MATHILDA KOIVOGUI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1740 W TAYLOR ST, CHICAGO, IL 60612-7232
(248) 247-4121
Mailing address
1740 W TAYLOR ST, CHICAGO, IL 60612-7232
(248) 247-4121
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041490259
IL
Other
Enumeration date
06/05/2025
Last updated
06/05/2025
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