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General NPI Number Information
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NPI Number | 1194290908
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Entity Type | Individual
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Provider Name | CHARISSE WASHINGTON NP-C
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Gender | Female
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Dates
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Enumeration Date | 10/08/2018
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Last Update Date | 10/08/2018
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Provider Practice Location Address
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Address Line | 34 E OAK ST
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City | CHICAGO
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State | IL
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Zip | 60611-1231
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Country | US
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Telephone | 312-915-0195
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Fax |
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Provider Business Mailing Address
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Address Line | 527 E BOWEN AVE APT 1
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City | CHICAGO
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State | IL
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Zip | 60653-4083
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209.017999
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License Number State | IL
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