Doctor Name: | PHILOMINA TONI |
NPI Number: | 1265891865 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 209.013823 |
Business Practice Address: | 5732 Lyons St Morton Grove, IL - 600531549 |
Business Phone Number: | 8472174779 |
Business Fax Number: | |
Mailing Address: | 5732 Lyons St, MORTON GROVE |
State: | IL |
Postal Code: | 600531549 |
Phone Number: | 8472174779 |
Fax Number: | |
NPI Enumeration Date: | 02/11/2016 |
NPI Last Update Date: | 02/11/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 209.013823 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |