Individual
BRANDY WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
2535 S KING DR, CHICAGO, IL 60616-4746
(312) 674-5972
Mailing address
2535 S KING DR, CHICAGO, IL 60616-4746
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209.028623
IL
363LF0000X
Family Nurse Practitioner
209.028623
IL
Other
Enumeration date
12/05/2023
Last updated
12/05/2023
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