Individual
MICHAEL ANTHONY SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1414 N AUSTIN BLVD, 3W, OAK PARK, IL 60302-1174
(773) 991-0960
Mailing address
1414 N AUSTIN BLVD, 3W, OAK PARK, IL 60302-1174
(773) 991-0960
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041387765
IL
164W00000X
Licensed Practical Nurse
043100800
IL
164W00000X
Licensed Practical Nurse
LPN078306
GA
Other
Enumeration date
12/02/2010
Last updated
12/02/2010
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