Individual
ASHLEY BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
6501 S PROMONTORY DR, CHICAGO, IL 60649-1003
(773) 256-5746
Mailing address
1440 S MICHIGAN AVE APT 215, CHICAGO, IL 60605-2956
(708) 218-7694
Taxonomy
Speciality
Code
Description
License number
State
2080P0214X
Pediatric Pulmonology Physician
Primary
209015210
IL
363LP0200X
Pediatric Nurse Practitioner
209015210
IL
363LP2300X
Primary Care Nurse Practitioner
209015210
IL
Other
Enumeration date
10/16/2017
Last updated
01/18/2019
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