Individual
AKASSI GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTC
Contact information
Practice address
119 S WESTERN AVE # 227, CHICAGO, IL 60612-4643
(872) 210-0900
Mailing address
3134 W 76TH ST, CHICAGO, IL 60652-1968
(872) 210-0900
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
1401102818
IL
Other
Enumeration date
06/29/2017
Last updated
04/25/2025
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