Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 209.013484 | IL |
NPI | 1023481744 |
---|---|
Provider Name | Michelle Audrey Calvario |
First Address | Chicago, IL 60611-2914 |
Second Address | Chicago, IL 60611-2914 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2015 |
Last Update Date | 28/08/2020 |