Individual
LEBORDIA KEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
655 W 65TH ST, CHICAGO, IL 60621-2631
(773) 664-7513
Mailing address
3015 SUNNYSIDE AVE, BROOKFIELD, IL 60513-1051
(312) 221-3447
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
09/11/2023
Last updated
09/11/2023
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