Individual
MALLIA EIHENTALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
921 DRAKE RD, GLENVIEW, IL 60025-4319
(773) 732-8625
Mailing address
921 DRAKE RD, GLENVIEW, IL 60025-4319
(773) 732-8625
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209.018102
IL
Other
Enumeration date
09/11/2020
Last updated
04/22/2025
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