Individual
DERWANDER POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
10343 S WESTERN AVE, CHICAGO, IL 60643-2410
(773) 238-2828
Mailing address
441 W 96TH PL, CHICAGO, IL 60628-1143
(773) 457-2795
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209022580
IL
Other
Enumeration date
01/06/2021
Last updated
01/06/2021
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