Individual
MISS MINI A NEDUMGOTTIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
5TH & ROOSEVELT RD, HINES, IL 60141
(708) 202-8387
Mailing address
362 FOSTER WAY, BOLINGBROOK, IL 60440
(708) 202-8387
Taxonomy
Speciality
Code
Description
License number
State
283X00000X
Rehabilitation Hospital
Primary
—
IL
Other
Enumeration date
10/02/2006
Last updated
07/08/2007
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