Individual
SQUAVETTE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1015 W LAWRENCE AVE, CHICAGO, IL 60640-5017
(773) 275-2586
Mailing address
1015 W LAWRENCE AVE, CHICAGO, IL 60640-5017
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041.372571
IL
Other
Enumeration date
01/05/2023
Last updated
01/05/2023
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