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Individual

UNICE LEE WOODS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
80 E CERMAK RD, A1, CHICAGO, IL 60616-2123
(312) 794-5193
(312) 794-5286
Mailing address
80 E CERMAK RD, A1, CHICAGO, IL 60616-2123
(312) 794-5193
(312) 794-5286

Taxonomy

Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
141939646
TAX IDENIFICATION NUMBER
IL
Enumeration date
01/14/2011
Last updated
01/14/2011
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