Individual
EVELYN UKPOLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
148 S BOLINGBROOK DR, BOLINGBROOK, IL 60440-2852
(630) 914-5373
Mailing address
217 CHRISTINE WAY, BOLINGBROOK, IL 60440-6138
(773) 540-6231
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
277003205
IL
Other
Enumeration date
10/07/2014
Last updated
09/27/2024
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