Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 041457241 | IL |
NPI | 1023661980 |
---|---|
Provider Name | Margaret Clemons-Adams |
First Address | Frankfort, IL 60423-1540 |
Second Address | Chicago, IL 60609-3701 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2019 |
Last Update Date | 19/07/2019 |