Individual
MS. DIANE L BALDACCI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
2701 W 68TH ST, CHICAGO, IL 60629-1813
(773) 884-4810
(773) 884-8093
Mailing address
2736 BIMINI LN, NEW LENOX, IL 60451-9206
(815) 463-1770
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070-002935
IL
Other
Enumeration date
05/12/2006
Last updated
07/31/2012
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