Individual
MRS. ELONDA EVETTE VANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4242 W ADAMS ST APT 2F, CHICAGO, IL 60624-2655
(773) 708-0083
Mailing address
4242 W ADAMS ST APT 2F, CHICAGO, IL 60624-2655
(773) 708-0083
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043.102843
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164W00000X
—
IL
Enumeration date
04/07/2021
Last updated
04/07/2021
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