Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 209.008919 | IL |
NPI | 1013258987 |
---|---|
Provider Name | Erin Le Breton |
First Address | Palatine, IL 60078-1848 |
Second Address | Palatine, IL 60067-6968 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2013 |
Last Update Date | 16/09/2016 |