Individual
ANNA-MICHELLE VISAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.-C
Contact information
Practice address
2171 W EXECUTIVE DR, ADDISON, IL 60101-5625
(630) 317-3300
Mailing address
447 N TRUE ST, GRIFFITH, IN 46319-2677
(219) 381-0695
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28214854A
IN
363LF0000X
Family Nurse Practitioner
Primary
209013448
IL
Other
Enumeration date
12/11/2015
Last updated
12/11/2015
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