Individual
KISHA DANIEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4413 ROOSEVELT RD STE 100, HILLSIDE, IL 60162-2057
(773) 425-1201
Mailing address
3449 W MONROE ST, CHICAGO, IL 60624-2957
(312) 709-0400
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227.017709
IL
Other
Enumeration date
02/20/2023
Last updated
02/20/2023
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