Individual
CHARITY POLK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
49 SUNDANCE RD, MATTESON, IL 60443-1284
(708) 215-4335
Mailing address
49 SUNDANCE RD, MATTESON, IL 60443-1284
(708) 215-4335
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2026018821
IL
Other
Enumeration date
06/09/2026
Last updated
06/09/2026
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