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Individual

JAN ODIAGA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DNP CPNP

Contact information

Practice address
511 DUNDEE AVE, EAST DUNDEE, IL 60118-1642
(847) 844-3274
Mailing address
511 DUNDEE AVE, EAST DUNDEE, IL 60118-1642

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
209.003792
IL

Other

Enumeration date
09/25/2010
Last updated
09/25/2010
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