Individual
MICHELLE COBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8327 S LOOMIS BLVD, CHICAGO, IL 60620-3958
(708) 573-6342
Mailing address
8327 S LOOMIS BLVD, CHICAGO, IL 60620-3958
(708) 573-6342
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
—
Other
Enumeration date
08/17/2020
Last updated
08/17/2020
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