Individual
MRS. TAMMIE HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
400 S KENNEDY DR, SUITE 900, BRADLEY, IL 60915-2682
(815) 932-3132
(815) 932-2397
Mailing address
400 S KENNEDY DR, SUITE 900, BRADLEY, IL 60915-2682
(815) 932-3132
(815) 932-2397
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
209011570
IL
Other
Enumeration date
08/18/2014
Last updated
08/18/2014
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