Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 20917591 | IL |
NPI | 1033609508 |
---|---|
Provider Name | Lindsey Gradone |
First Address | Chicago, IL 60615-6134 |
Second Address | Chicago, IL 60611-2908 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2018 |
Last Update Date | 10/05/2018 |