Individual
GLENNA M DAUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN-CNP
Contact information
Practice address
2650 RIDGE AVE., EMERGENCY MEDICINE, EVANSTON, IL 60201-1718
(847) 570-2114
(847) 570-1223
Mailing address
2650 RIDGE AVE., EMERGENCY MEDICINE, EVANSTON, IL 60201-1718
(847) 570-2114
(847) 570-1223
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209.016628
IL
Other
Enumeration date
02/01/2018
Last updated
02/06/2020
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