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Individual

VICTORIA PORTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
473 W ARMY TRAIL RD STE 103, BLOOMINGDALE, IL 60108-2674
(630) 529-6969
Mailing address
473 W ARMY TRAIL RD STE 103, BLOOMINGDALE, IL 60108-2674
(630) 529-6969

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.453173
IL
363LP0200X
Pediatric Nurse Practitioner
Primary
209.026252
IL

Other

Enumeration date
12/23/2022
Last updated
06/20/2024
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