Individual
DANIELLE NICOLE LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
240 E HURON ST, MCGAW MEDICAL CENTER OF NORTHWESTERN UNIVSERSITY, CHICAGO, IL 60611-2909
(312) 503-7975
Mailing address
145 COMMERCIAL ST, APT. 332, BOSTON, MA 02109-1319
(651) 808-0762
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
036.145860
IL
Other
Enumeration date
04/14/2014
Last updated
12/20/2018
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