Provider Information for 1346745916
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Miss GENEEN RENEE MCGOWAN
Sex: Female
NPI: 1346745916
Last Updated: 2023-02-17
Certification Date: 2023-02-17
Certification Date: 2023-02-17
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1346745916 | ||||||||||||
| Enumeration Date | 2018-03-27 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 7050 S MERRILL AVE APT 405 CHICAGO, IL 60649-2181 United States Phone: 773-699-1986 | Fax:773-420-3555 | ||||||||||||
| Primary Practice Address | 7050 S MERRILL AVE APT 405 CHICAGO, IL 60649-2181 United States Phone: 773-699-1986 | Fax:773-420-3555 | ||||||||||||
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