Individual provider · Type 1 NPI

Iyeokan Emmanuela Ativie, FNP-C

Family Nurse Practitioner · New Lenox, IL

NPI number 1205421815 Active

Practice location

2050 Nelson Rd
New Lenox, IL 60451-8537

Mailing address

3001 S King Dr Apt 1801
Chicago, IL 60616-3330

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000X209022852 (IL)

Family Nurse Practitioner: Definition to come...

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About NPI 1205421815

Iyeokan Emmanuela Ativie, FNP-C's National Provider Identifier is 1205421815, issued on Mar 5, 2021. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in New Lenox, IL. The record was last updated on Mar 5, 2021.