Individual
DIANA HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5304 PINE TRAILS CIR, PLAINFIELD, IL 60586-7641
(773) 658-5623
Mailing address
5304 PINE TRAILS CIR, PLAINFIELD, IL 60586-7641
(773) 658-5623
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043123088
IL
Other
Enumeration date
09/28/2016
Last updated
09/28/2016
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