Individual
LIMARIZ REBOLLEDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5635 W BELMONT AVE, CHICAGO, IL 60634-4384
(773) 736-1830
Mailing address
507 N 17TH ST, MILWAUKEE, WI 53233-2104
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.010814
IL
Other
Enumeration date
08/09/2024
Last updated
09/25/2024
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