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Individual

CRYSTAL MEDINA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APN

Contact information

Practice address
2233 W DIVISION ST, CHICAGO, IL 60622-8151
(312) 770-3524
Mailing address
2049 N BINGHAM ST, CHICAGO, IL 60647-4031
(773) 954-9215

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209014941
IL

Other

Enumeration date
01/30/2017
Last updated
01/30/2017
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