Individual
MS. ENES MUGNOLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGPCNP
Contact information
Practice address
1088 KUFRIN WAY, LOMBARD, IL 60148-3429
(630) 484-5094
Mailing address
PO BOX 7405, VILLA PARK, IL 60181-7405
(630) 484-5094
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
209.014796
IL
363LG0600X
Gerontology Nurse Practitioner
209.014796
IL
Other
Enumeration date
06/20/2017
Last updated
06/20/2017
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