Individual
JACQUELINE KONRAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1328 N LEAVITT ST, CHICAGO, IL 60622-3026
(773) 931-4072
Mailing address
1328 N LEAVITT ST, CHICAGO, IL 60622-3026
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160006956
IL
Other
Enumeration date
03/04/2015
Last updated
03/04/2015
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