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General NPI Number Information
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NPI Number | 1306313663
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Entity Type | Individual
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Provider Name | FELICIA ADU-POKU
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Gender | Female
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Dates
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Enumeration Date | 10/25/2018
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Last Update Date | 10/25/2018
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Provider Practice Location Address
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Address Line | 818 HUNTLEY WOODS DR
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City | CRETE
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State | IL
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Zip | 60417-1387
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Country | US
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Telephone | 708-279-4830
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Fax |
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Provider Business Mailing Address
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Address Line | 818 HUNTLEY WOODS DR
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City | CRETE
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State | IL
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Zip | 60417-1387
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Country | US
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Telephone | 708-279-4830
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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 | 209.017589
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License Number State | IL
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