Individual
JOHANA D HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
5710 N BROADWAY ST, CHICAGO, IL 60660-4302
(773) 728-1000
Mailing address
14818 KILDARE AVE, MIDLOTHIAN, IL 60445-3338
(224) 283-4015
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041439038
IL
Other
Enumeration date
05/29/2018
Last updated
05/29/2018
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