Individual
MARA NICANDRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NMT, LMT
Contact information
Practice address
2225 W NORTH AVE, ELEMENTAL HEALTH, CHICAGO, IL 60647-5429
(312) 451-5771
Mailing address
2225 W NORTH AVE, ELEMENTAL HEALTH, CHICAGO, IL 60647-5429
(312) 451-5771
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
227.013372
IL
Other
Enumeration date
08/29/2014
Last updated
08/29/2014
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