Individual
MRS. SANDRE LEONA CRAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
17066 S PARK AVE, SOUTH HOLLAND, IL 60473-3369
(708) 882-0532
(647) 799-2792
Mailing address
9718 S HALSTED ST, CHICAGO, IL 60628-1007
(773) 233-4100
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
209.016571
IL
363LP2300X
Primary Care Nurse Practitioner
Primary
209.016571
IL
Other
Enumeration date
10/11/2017
Last updated
02/15/2022
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