Individual
MADISON ERICA MASKALUNAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
911 CHURCH ST, EVANSTON, IL 60201
(847) 919-9096
Mailing address
911 CHURCH ST, EVANSTON, IL 60201
(847) 919-9096
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209029395
IL
Other
Enumeration date
03/12/2024
Last updated
03/12/2024
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