Individual
ITA MEYSTEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6725 N MOZART ST, CHICAGO, IL 60645-4309
(773) 262-1164
Mailing address
6725 N MOZART ST, CHICAGO, IL 60645-4309
(773) 262-1164
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146010797
IL
Other
Enumeration date
06/29/2015
Last updated
06/29/2015
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