Individual
LAVETTE O'NEAL-REESE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14241 S STEWART AVE, RIVERDALE, IL 60827-2339
(708) 699-4487
Mailing address
14241 S STEWART AVE, RIVERDALE, IL 60827-2339
(708) 699-4487
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
O54653779948
IL
Other
Enumeration date
02/26/2016
Last updated
02/26/2016
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