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Individual

HENELIE MAY GEGANTENIO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
FNP-BC

Contact information

Practice address
4552 MADISON ST, SKOKIE, IL 60076-2667
(847) 372-8584
Mailing address
4552 MADISON ST, SKOKIE, IL 60076-2667
(847) 372-8584

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209020073
IL

Other

Enumeration date
11/06/2019
Last updated
11/06/2019
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