Organization
COMPASSIONATE PROVIDER SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRACE ENEOGWE FNP (OWNER)
(773) 680-7388
Entity
Organization
Contact information
Practice address
795 CITADEL CT, DES PLAINES, IL 60016-6489
(773) 680-7388
Mailing address
795 CITADEL CT, DES PLAINES, IL 60016-6489
(773) 680-7388
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209-007655
IL
Other
Enumeration date
03/09/2017
Last updated
03/09/2017
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