Individual
MARIA ALFAJORA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
7603 N NORA AVE, NILES, IL 60714-4728
(847) 962-2842
Mailing address
7603 N NORA AVE, NILES, IL 60714-4728
(847) 962-2842
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160006266
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A41255187849
DRIVERS LICENSE
IL
Enumeration date
04/04/2017
Last updated
06/06/2021
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