Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 209013376 | IL |
NPI | 1073983789 |
---|---|
Provider Name | Elodie Schembri |
First Address | Plainfield, IL 60544-2313 |
Second Address | Plainfield, IL 60544-2313 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/10/2015 |
Last Update Date | 03/11/2016 |