Individual
ANDREA DENISE POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3510 W 79TH ST, CHICAGO, IL 60652-1430
(773) 978-0757
Mailing address
3510 W 79TH ST, CHICAGO, IL 60652-1430
(773) 978-0757
(773) 978-0705
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209021507
IL
Other
Enumeration date
05/30/2020
Last updated
03/16/2021
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