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Individual

ANITA SIMS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
18612 MAPLE AVE, COUNTRY CLUB HILLS, IL 60478-5692
(630) 886-6513
Mailing address
18612 MAPLE AVE, COUNTRY CLUB HILLS, IL 60478-5692
(630) 886-6513

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
S52000182654
IL

Other

Enumeration date
03/23/2015
Last updated
03/23/2015
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