Individual
URSLA U NWAWUEZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
8201 S ASHLAND AVE, CHICAGO, IL 60620-4626
(708) 262-8344
Mailing address
59 DEERPATH RD, MATTESON, IL 60443-1125
(708) 262-8344
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209022911
IL
Other
Enumeration date
04/05/2021
Last updated
06/09/2021
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