Individual
MS. CANDACE JEANINE COLLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
925 E 46TH ST, CHICAGO, IL 60653-3638
(773) 343-3060
Mailing address
925 E 46TH ST, CHICAGO, IL 60653-3638
(773) 343-3060
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
05/24/2013
Last updated
05/24/2013
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