Individual
MS. VITA KAY HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5642 W DIVERSEY AVE, CHICAGO, IL 60639-1353
(708) 465-1293
(708) 575-3167
Mailing address
8110 S PRINCETON AVE, CHICAGO, IL 60620-1716
(312) 933-9697
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
178.013064
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1891119590
RIMYA
IL
Enumeration date
05/23/2018
Last updated
05/23/2018
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