Individual
MS. REGINA WHITTMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7808 S COLES AVE APT 3, CHICAGO, IL 60649
(312) 248-5645
Mailing address
7808 S COLES AVE APT 3, CHICAGO, IL 60649
(312) 248-5645
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
06/27/2016
Last updated
06/27/2016
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