Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | 036.101944 | IL |
NPI | 1295769297 |
---|---|
Provider Name | Yolanda F Holler-Managan |
First Address | Winfield, IL 60190 |
Second Address | Winfield, IL 60190 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 07/09/2016 |