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MRS. MARY GRACE BRIGGS PONTE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
1942 DEMPSTER ST, EVANSTON, IL 60202-1016
(847) 688-1900
(847) 869-7392
Mailing address
1942 DEMPSTER ST., EVANSTON, IL 60202
(847) 688-1900
(847) 869-7392

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043113661
IL

Other

Enumeration date
04/20/2023
Last updated
04/20/2023
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