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Individual

BASIRAT ROMOKE BALE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APN, DNP

Contact information

Practice address
5841 S MARYLAND AVE, CHICAGO, IL 60637-1443
(773) 834-4946
(773) 834-2058
Mailing address
9745 S KARLOV AVE, APT. 203, OAK LAWN, IL 60453-3389
(708) 299-3064

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209014251
IL

Other

Enumeration date
11/18/2016
Last updated
07/03/2020
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