Individual
SARA DIANA MIRANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
5425 W LAKE ST, CHICAGO, IL 60644-2342
(773) 378-3347
Mailing address
645 S CENTRAL AVE, SUITE 600, CHICAGO, IL 60644-5059
(773) 537-0020
(773) 537-0029
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209012136
IL
Other
Enumeration date
09/03/2014
Last updated
12/26/2019
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