Organization
PRIMARY HEALTH & NUTRITION SERVICES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN LEWIS R.N.CDDN (RN)
(815) 546-9496
Entity
Organization
Contact information
Practice address
514 COTTONWOOD RD, FRANKFORT, IL 60423-1010
(815) 546-9496
(815) 469-4136
Mailing address
514 COTTONWOOD RD, FRANKFORT, IL 60423-1010
(815) 546-9496
(815) 469-4136
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041-249653
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
360-62-0745-001
—
IL
Enumeration date
03/04/2017
Last updated
03/04/2017
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