Individual
MITSUKO MIMI MALONEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8124 ROSEBURY AVE, WOODRIDGE, IL 60517-7736
(630) 207-6879
Mailing address
8124 ROSEBURY AVE, WOODRIDGE, IL 60517-7736
(630) 207-6879
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
08/06/2019
Last updated
08/06/2019
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