Individual
CLEAUQUITA WILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
2727 W 97TH ST, EVERGREEN PARK, IL 60805-2733
(773) 732-3770
Mailing address
2727 W 97TH ST, EVERGREEN PARK, IL 60805-2733
(773) 732-3770
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
041-353003
IL
363L00000X
Nurse Practitioner
Primary
209.024630
IL
Other
Enumeration date
08/28/2007
Last updated
02/16/2022
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