Individual
DAISY WYNN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2418 W DIVISION ST, CHICAGO, IL 60622-2940
(203) 686-1677
Mailing address
2418 W DIVISION ST, CHICAGO, IL 60622-2940
(312) 666-3494
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036133013
IL
207Q00000X
Family Medicine Physician
047947
CT
Other
Enumeration date
04/18/2007
Last updated
08/10/2021
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