Individual
BRIANA NICOLE O'DONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(570) 956-1868
Mailing address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036164996
IL
207R00000X
Internal Medicine Physician
125.075730
IL
Other
Enumeration date
03/26/2020
Last updated
07/14/2023
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