Individual
MR. CARLETON BRUCE SYPH II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5820 S WESTERN AVE, CHICAGO, IL 60636-1527
(224) 725-0765
Mailing address
848 DODGE AVE # 426, EVANSTON, IL 60202-1506
(224) 725-0765
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
IL
Other
Enumeration date
10/03/2024
Last updated
10/03/2024
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