Individual
DR. LAUREL ANN DETTORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNSC, MS, RN
Contact information
Practice address
6827 STANLEY AVE, BERWYN, IL 60402-3287
(708) 795-1520
(708) 795-1543
Mailing address
6827 STANLEY AVE, BERWYN, IL 60402-3287
(708) 795-1520
(708) 795-1543
Taxonomy
Speciality
Code
Description
License number
State
363LC1500X
Community Health Nurse Practitioner
Primary
214132
IL
Other
Enumeration date
07/13/2012
Last updated
07/13/2012
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