Individual provider · Type 1 NPI
Audrey Oetomo
Pediatric Nurse Practitioner · Chicago, IL
NPI number
1457789315
Active
Practice location
5841 S Maryland Ave
Chicago, IL 60637-1443
Mailing address
150 Harvester Dr, Suite 300
Burr Ridge, IL 60527-5919
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Nurse Practitioner Primary | 363LP0200X | 209013763 (IL) |
Pediatric Nurse Practitioner: Definition to come...
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About NPI 1457789315
Audrey Oetomo's National Provider Identifier is 1457789315, issued on Oct 30, 2013. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Chicago, IL. The record was last updated on Oct 24, 2022.