Individual
MARY KAY GAWNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
20 S CLARK ST, SUITE 1100, CHICAGO, IL 60603-1802
(312) 926-7443
Mailing address
20 S CLARK ST, SUITE 1100, CHICAGO, IL 60603-1802
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209-001604
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036071152
—
IL
Enumeration date
07/28/2006
Last updated
04/10/2018
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