Individual
MARY EILEEN GRIMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2320 W 113TH PL, CHICAGO, IL 60643-4117
(773) 474-7386
Mailing address
2320 W 113TH PL, CHICAGO, IL 60643-4117
(773) 474-7386
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160007467
IL
Other
Enumeration date
05/07/2024
Last updated
05/07/2024
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