Healthcare Provider Details

I. General information

NPI: 1508774068
Provider Name (Legal Business Name): MONICA ELIZABETH OWENS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3015 HAROLDS CRES
FLOSSMOOR IL
60422-2009
US

IV. Provider business mailing address

1037 REGENT DR
MATTESON IL
60443-3090
US

V. Phone/Fax

Practice location:
  • Phone: 708-420-6057
  • Fax:
Mailing address:
  • Phone: 708-910-8054
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041.359651
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: