Dr. Laurel Ann Dettore
Nurse Practitioner - Community Health
6827 Stanley Ave
Berwyn
, Illinois 60402-3287
Dr. Laurel Ann Dettore
Nurse Practitioner - Community Health
6827 Stanley Ave
Berwyn
, Illinois 60402-3287
(708) 795-1543
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About
Features
Specialties
- Nurse Practitioner - Community Health
Languages spoken
- English
Location
First Address
- Dr. Laurel Ann Dettore
- 6827 Stanley Ave
- Berwyn, IL
- Zip : 60402-3287
- Fax : (708) 795-1543
- Phone : (708) 795-1520
Second Address
- Dr. Laurel Ann Dettore
- 6827 Stanley Ave
- Berwyn, IL
- Zip : 60402-3287
- Fax : (708) 795-1543
- Phone : (708) 795-1520
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FAQs
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Is Dr. Laurel Ann Dettore a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LC1500X | Nurse Practitioner - Community Health | 214132 | IL |
National Provider Identifier
| NPI | 1689929879 |
|---|---|
| Provider Name | Dr. Laurel Ann Dettore |
| First Address | Berwyn, IL 60402-3287 |
| Second Address | Berwyn, IL 60402-3287 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 13/07/2012 |
| Last Update Date | 13/07/2012 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.