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General NPI Number Information
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NPI Number | 1295286755
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Entity Type | Individual
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Provider Name | MARGARET KETTNER SALAS FNP-C
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Gender | Female
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Dates
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Enumeration Date | 10/20/2016
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Last Update Date | 10/20/2016
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Provider Practice Location Address
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Address Line | 103 SCHELTER RD STE 30
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City | LINCOLNSHIRE
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State | IL
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Zip | 60069-3657
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Country | US
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Telephone | 847-821-0074
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Fax |
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Provider Business Mailing Address
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Address Line | 8701 E TANQUE VERDE RD UNIT 93
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City | TUCSON
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State | AZ
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Zip | 85749-6508
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Country | US
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Telephone | 520-561-4695
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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 | AP9574
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License Number State | AZ
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