Individual
BIANCA ALS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6930 ROOSEVELT RD, OAK PARK, IL 60304-1845
(708) 358-3000
Mailing address
4742 S INGLESIDE AVE, CHICAGO, IL 60615-1812
(773) 485-2188
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
A42007488838
IL
Other
Enumeration date
08/15/2019
Last updated
08/15/2019
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