Individual
KASEY L WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8135 CALUMET AVE, MUNSTER, IN 46321-1701
(219) 513-2000
Mailing address
40 75TH ST, WILLOWBROOK, IL 60527-2325
(630) 581-5372
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041438110
IL
363L00000X
Nurse Practitioner
Primary
209.026891
IL
Other
Enumeration date
12/14/2022
Last updated
06/06/2024
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