Individual
MS. CHARIS MARIE HABERCOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-2653
(708) 216-6829
Mailing address
2160 S 1ST AVE BLDG 110, MAYWOOD, IL 60153-3328
(708) 216-2653
(708) 216-6829
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209.008136
IL
Other
Enumeration date
03/09/2011
Last updated
03/09/2011
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