Individual
MS. WANDA HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7837 S LANGLEY AVE, CHICAGO, IL 60619-3009
(773) 983-7090
Mailing address
7837 S LANGLEY AVE, CHICAGO, IL 60619-3009
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1484750
IL
Other
Enumeration date
10/30/2012
Last updated
10/30/2012
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