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Individual

JOSEPH SPAGNOLA III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
NP, FPA, PMHNP-BC

Contact information

Practice address
3249 OAK PARK AVE, BERWYN, IL 60402-3429
(708) 783-9100
Mailing address
3249 OAK PARK AVE, BERWYN, IL 60402-3429

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
277002403
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
209017357
IL

Other

Enumeration date
05/11/2018
Last updated
08/08/2023
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