Individual
JHADA BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
600 S PAULINA ST, CHICAGO, IL 60612-3806
(312) 942-7100
Mailing address
828 S LOOMIS ST APT 3, CHICAGO, IL 60607-4081
(954) 854-4687
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
IL
Other
Enumeration date
06/04/2024
Last updated
06/04/2024
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