Individual
MRS. ANGELICA MARIA DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
6500 W 65TH ST, CHICAGO, IL 60638-4962
(708) 496-1515
(708) 496-3422
Mailing address
3441 S 61ST AVE, CICERO, IL 60804-3748
(708) 656-5363
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160002275
IL
Other
Enumeration date
10/04/2007
Last updated
10/04/2007
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