Individual
MRS. CONNIE S BANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
318 MOHAWK ST, PARK FOREST, IL 60466-1908
(708) 932-4193
Mailing address
318 MOHAWK ST, PARK FOREST, IL 60466-1908
(708) 932-4193
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.001461
IL
Other
Enumeration date
05/01/2008
Last updated
05/01/2008
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