Organization
LANGUAGE LEGACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS MICHELLE ANNALOU RUSH M.A.L.S. ESL (EDUCATOR)
(708) 368-7482
Entity
Organization
Contact information
Practice address
14507 PULASKI RD APT 1, MIDLOTHIAN, IL 60445-2850
(708) 368-7482
Mailing address
PO BOX 242, MIDLOTHIAN, IL 60445-0242
(708) 368-7482
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
2338618
IL
Other
Enumeration date
05/26/2016
Last updated
05/26/2016
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