Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | IL |
NPI | 1013199926 |
---|---|
Provider Name | Antoinette V Ahr |
First Address | Skokie, IL 60076-1266 |
Second Address | Skokie, IL 60076-1266 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2007 |
Last Update Date | 03/12/2007 |