Individual
LESLIE MENDOZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10046 S WESTERN AVE, CHICAGO, IL 60643-1926
(773) 290-5842
Mailing address
3605 W. FILLMORE ST., CHICAGO, IL 60624
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/01/2016
Last updated
09/01/2016
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