Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 038011300 | IL |
NPI | 1003140567 |
---|---|
Provider Name | Miss Andrea Kay Mursu |
First Address | Glenview, IL 60026-8024 |
Second Address | Glenview, IL 60026-8024 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2009 |
Last Update Date | 13/01/2011 |