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Individual

MARNITA INGRAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1969 W OGDEN AVE, CHICAGO, IL 60612-3765
(708) 391-4081
Mailing address
20301 ARCADIAN DR, OLYMPIA FIELDS, IL 60461-1301
(708) 391-4081

Taxonomy

Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
041.337473
IL
163WC0400X
Case Management Registered Nurse
041337473
IL

Other

Enumeration date
12/12/2024
Last updated
12/12/2024
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