Individual
DIANA FUNMILOLA WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
31 W 155TH ST, HARVEY, IL 60426-3556
(708) 596-5177
Mailing address
31 W 155TH ST, HARVEY, IL 60426-3556
(708) 596-5177
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209018551
IL
Other
Enumeration date
12/21/2018
Last updated
12/21/2018
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