Individual
LA TONYA ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
956 E 152ND ST, SOUTH HOLLAND, IL 60473-1142
(773) 354-5656
Mailing address
956 E 152ND ST, SOUTH HOLLAND, IL 60473-1142
(773) 354-5656
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
209022426
IL
Other
Enumeration date
11/21/2020
Last updated
11/21/2020
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