Provider Demographics
NPI:1942173810
Name:PRYOR, LATANJIA DENISE (RN)
Entity type:Individual
Prefix:MS
First Name:LATANJIA
Middle Name:DENISE
Last Name:PRYOR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:676 N SAINT CLAIR ST STE 900
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2977
Mailing Address - Country:US
Mailing Address - Phone:312-926-3155
Mailing Address - Fax:312-926-1787
Practice Address - Street 1:676 N SAINT CLAIR ST STE 900
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2977
Practice Address - Country:US
Practice Address - Phone:312-926-3155
Practice Address - Fax:312-926-1787
Is Sole Proprietor?:No
Enumeration Date:2025-09-26
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041335096163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse