MEDICARE: MRS. JOYCE N ONYENSO REGISTERED NURSE

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
1	163WA2000X	Administrator Registered Nurse		IL

General Provider Information

NPI Number	:	1255504155
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JOYCE N ONYENSO REGISTERED NURSE

Provider Business Mailing Address
First Line	:	1037 MONTEREY CT
Second Line	:
City	:	UNIVERSITY PARK
State	:	IL
Zip	:	60466
Country	:	US
Telephone Number	:	708-534-6144
Fax Number	:

Provider Business Practice Location Address
First Line	:	1037 MONTEREY CT
Second Line	:
City	:	UNIVERSITY PARK
State	:	IL
Zip	:	60466
Country	:	US
Telephone Number	:	708-534-6144
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/11/2008
Last Update Date	:	04/11/2008

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