Individual
TANYA RETTIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
7804 WOODED SHORE DR, WONDER LAKE, IL 60097-9312
(815) 388-2424
Mailing address
1803 OKLAHOMA AVE, GREAT LAKES, IL 60088-4214
(815) 388-2424
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209017713
IL
Other
Enumeration date
10/30/2018
Last updated
10/30/2018
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