IndividualActive
Laurel Dettore, DNSC, MS, RN
NPI 1689929879 · Community Health Nurse Practitioner · Berwyn, IL
Provider details
- NPI number
- 1689929879
- Entity type
- Individual
- Primary specialty
- Community Health Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- DNSC, MS, RN
- Sex
- Female
- Sole proprietor
- Yes
- License
- 214132 (IL)
Practice location
6827 Stanley Ave
Berwyn, IL 60402-3287
Phone: (708) 795-1520
Fax: (708) 795-1543
Mailing address
6827 Stanley Ave
Berwyn, IL 60402-3287
Registry dates
- Enumerated
- 2012-07-13
- Last updated
- 2012-07-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.