Individual
ALEXA GRACE REBOLLEDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
5828 W HENDERSON ST, CHICAGO, IL 60634-4301
(312) 918-7846
Mailing address
5828 W HENDERSON ST, CHICAGO, IL 60634-4301
(312) 918-7846
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
03/31/2018
Last updated
03/31/2018
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