Individual
PATRICIA AVINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
4053 W 58TH ST, CHICAGO, IL 60629-4432
(773) 593-0731
Mailing address
4053 W 58TH ST, CHICAGO, IL 60629-4432
(773) 593-0731
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160006208
IL
Other
Enumeration date
11/28/2012
Last updated
11/28/2012
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