Individual
CORETTA J PRUITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
641 W 63RD ST, CHICAGO, IL 60621-2032
(224) 531-7966
(312) 355-1110
Mailing address
641 W 63RD ST, CHICAGO, IL 60621-2032
(224) 531-7966
(312) 355-1110
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/08/2019
Last updated
03/08/2019
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