Individual
KEISHA NICOLE HOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3240 W DIVISION ST, CHICAGO, IL 60651-2405
(312) 413-7425
(312) 413-2588
Mailing address
3240 W DIVISION ST, CHICAGO, IL 60651-2405
(312) 413-7425
(312) 413-2588
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
277000995
IL
Other
Enumeration date
04/04/2017
Last updated
01/13/2021
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