Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 209.009991 | IL |
NPI | 1023455623 |
---|---|
Provider Name | Dawn Michele Szarke |
First Address | Mettawa, IL 60045-3411 |
Second Address | Usaf Academy, CO 80840-2502 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2013 |
Last Update Date | 23/05/2013 |