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Individual

MRS. LORI MARLENE OVITZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1211 S PRAIRIE AVE APT 2301, CHICAGO, IL 60605-3654
(312) 420-5610
Mailing address
1211 S PRAIRIE AVE APT 2301, CHICAGO, IL 60605-3654
(312) 420-5610

Taxonomy

Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
247200000X
IL

Other

Enumeration date
05/06/2013
Last updated
05/06/2013
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