Individual
MINA MILAD ANTONUOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6623 OAK FOREST AVE APT 12, TINLEY PARK, IL 60477-3569
(708) 518-5440
Mailing address
6623 OAK FOREST AVE APT 12, TINLEY PARK, IL 60477-3569
(708) 518-5440
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160008510
IL
Other
Enumeration date
01/28/2022
Last updated
01/28/2022
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