Individual
STELLA SHABA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
412 W 31ST ST, CHICAGO, IL 60616-3116
(312) 225-3119
Mailing address
412 W 31ST ST, CHICAGO, IL 60616-3116
(312) 225-3119
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160005907
IL
Other
Enumeration date
01/17/2012
Last updated
01/17/2012
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