Individual
JEANNE DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
9800 SOUTHWEST HWY, OAK LAWN, IL 60453-3617
(708) 229-6985
(708) 229-6931
Mailing address
9800 SOUTHWEST HWY, OAK LAWN, IL 60453-3617
(708) 229-6985
(708) 229-6931
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209003268
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209003268
LICENSE
IL
Enumeration date
08/25/2006
Last updated
10/24/2012
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