Individual
MARY ROSE SUPETRAN ONG-PEREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1133 HARBOR CT, GLENDALE HEIGHTS, IL 60139-3753
(630) 670-4290
Mailing address
1133 HARBOR CT, GLENDALE HEIGHTS, IL 60139-3753
(630) 670-4290
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0041-293484
IL
Other
Enumeration date
04/22/2016
Last updated
05/08/2016
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