Individual
CONSUELO PACHECO VILLABLANCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1765 N ELSTON AVE STE 206, CHICAGO, IL 60642-1501
(773) 998-8400
Mailing address
2212 SHERMAN AVE APT O2, EVANSTON, IL 60201-2833
(312) 998-9493
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070026174
IL
Other
Enumeration date
11/10/2021
Last updated
11/10/2021
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