Individual
MRS. MARY ANTOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
10002 S KOMENSKY AVE, OAK LAWN, IL 60453-4140
(708) 684-4969
(708) 684-1242
Mailing address
10002 S KOMENSKY AVE, OAK LAWN, IL 60453-4140
(708) 684-4969
(708) 684-1242
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
041.241416
IL
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
209.005136
IL
Other
Enumeration date
10/06/2009
Last updated
10/06/2009
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