Most Relevant Information
Provider Data
| NPI Number: | 1003351917 |
| Provider Name: | LAKESHA EALOM |
| Entity Type: | Individual |
| Taxonomy Code: | 163W00000X |
| Specialty: | Registered Nurse |
| License Number: | 041343237 |
Most Important Dates
| Enumeration Date: | 12/31/2016 |
| Last Updated: | 12/31/2016 |
Provider Practice Location
2825 S HALSTED ST
SUITE 311
CHICAGO
IL
606085962
Practice Location Phone/Fax
| Phone: | 7083943120 |
| Fax: |
Provider Mailing Location
2825 S HALSTED ST
SUITE 311
CHICAGO
IL
606085962
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |