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Individual

KRISTIAN SHUMATE GREENWELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1739 N ELSTON AVE, CHICAGO, IL 60642-1544
(773) 687-9241
Mailing address
2720 W CORTLAND ST APT 105, CHICAGO, IL 60647-5182
(270) 303-1313

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary

Other

Enumeration date
01/09/2018
Last updated
06/19/2023
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