Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | IL |
NPI | 1023125952 |
---|---|
Provider Name | Diane Nurceski |
First Address | Hinsdale, IL 60521-3634 |
Second Address | La Grange, IL 60525-2600 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2006 |
Last Update Date | 08/07/2007 |