Individual
KAIISHA DEAR SWEET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3408 W 95TH ST, EVERGREEN PARK, IL 60805-2204
(312) 504-1253
Mailing address
11302 S UNION AVE, CHICAGO, IL 60628-4726
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
—
IL
Other
Enumeration date
03/11/2019
Last updated
03/11/2019
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