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NPI Code Detail

MEDICARE: CURTISSA WARE

MEDICARE:   CURTISSA  WARE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164W00000XLicensed Practical Nurse04308122IL

General Provider Information

NPI Number : 1669845939
Entity Type Code : Individual
Provider Name (Legal Business Name) : CURTISSA WARE
Provider Business Mailing Address
First Line : 1037 N HARLEM AVE
Second Line : 1SA
City : OAK PARK
State : IL
Zip : 60302-1568
Country : US
Telephone Number : 708-383-1895
Fax Number :
Provider Business Practice Location Address
First Line : 1037 N HARLEM AVE
Second Line : 1SA
City : OAK PARK
State : IL
Zip : 60302-1568
Country : US
Telephone Number : 708-383-1895
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2015
Last Update Date : 11/08/2015

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Directions to “ CURTISSA WARE ” Practice Location

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