Individual
LEAH GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
516 W FRECH ST, STREATOR, IL 61364-1216
(815) 672-2600
Mailing address
409 N PEORIA ST, MAGNOLIA, IL 61336-9665
(815) 257-7117
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043.110933
IL
Other
Enumeration date
10/11/2021
Last updated
10/11/2021
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