IndividualActive
Larone Nutall
NPI 1063109296 · Contractor · Chicago, IL
Provider details
- NPI number
- 1063109296
- Entity type
- Individual
- Primary specialty
- ContractorOther Service Providers
- Sex
- Male
- Sole proprietor
- No
- License
- 095808 (IL)
Specialties & taxonomies
Other Service Providers
Practice location
7138 S Coles Ave Apt 2a
Chicago, IL 60649-2628
Phone: (708) 915-0517
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 490563
Chicago, IL 60649-0035
Registry dates
- Enumerated
- 2023-04-19
- Last updated
- 2023-04-19
- Certified
- 2023-04-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.