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Individual

MARITZA HERNANDEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1834 S MARK LN, ROUND LAKE, IL 60073-4289
(847) 546-9037
Mailing address
1834 S MARK LN, ROUND LAKE, IL 60073-4289
(847) 546-9037

Taxonomy

Speciality
Code
Description
License number
State
171R00000X
Interpreter
Primary
172A00000X
Driver

Other

Enumeration date
02/05/2010
Last updated
02/05/2010
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