Individual
GWEN ELIZABETH MEDRANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12211 S 44TH PL, ALSIP, IL 60803-2402
(708) 819-0443
Mailing address
12211 S 44TH PL, ALSIP, IL 60803-2402
(708) 819-0443
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
07/03/2017
Last updated
07/03/2017
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