Individual
DIANE JUDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1015 W LAWRENCE AVE, CHICAGO, IL 60640-5017
(773) 751-1704
(773) 751-4175
Mailing address
1015 W LAWRENCE AVE, CHICAGO, IL 60640-5017
(773) 751-1704
(773) 751-4175
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
309000612
IL
Other
Enumeration date
08/22/2005
Last updated
03/16/2015
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