Individual
MARY LEATHERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
1845 GRANDSTAND PL, ELGIN, IL 60123-6603
(847) 694-0484
(847) 695-1436
Mailing address
37W972 WILLOW LN, ELGIN, IL 60124-8571
(847) 741-9064
(847) 741-9064
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041206368
IL
Other
Enumeration date
01/19/2012
Last updated
01/19/2012
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