Individual
DANIELLE PORTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1136 S DELANO CT W, CHICAGO, IL 60605-3740
(773) 946-0642
Mailing address
620 E 101ST PL, CHICAGO, IL 60628-2242
(773) 946-0642
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
IL
Other
Enumeration date
04/14/2019
Last updated
04/14/2019
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