Individual
WILLA GREGG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1457 N LINDER AVE, CHICAGO, IL 60651-1233
(312) 203-9616
Mailing address
1457 N LINDER AVE, CHICAGO, IL 60651-1233
(312) 203-9616
(773) 237-0709
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
160.000756
IL
Other
Enumeration date
05/25/2016
Last updated
05/25/2016
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