Individual
MS. KIRA GIPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4715 W VAN BUREN ST, CHICAGO, IL 60644-4930
(470) 385-1395
Mailing address
PO BOX 3604, OAK BROOK, IL 60522-3604
(470) 385-1395
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043107339
IL
Other
Enumeration date
01/13/2021
Last updated
01/13/2021
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