Individual
BEATRICE VITAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2171 W EXECUTIVE DR STE 500, ADDISON, IL 60101-5626
(630) 766-0505
Mailing address
10853 S WHIPPLE ST, CHICAGO, IL 60655-2130
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.001113
IL
Other
Enumeration date
06/13/2017
Last updated
06/13/2017
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