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Individual

MISS DJEDAH PATES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
2710 N CLARK ST, CHICAGO, IL 60614-1503
(773) 244-0005
(773) 244-0006
Mailing address
1243 JUDSON AVE, APT 1, EVANSTON, IL 60202-1388
(847) 859-2372
(847) 859-2372

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070015089
IL

Other

Enumeration date
05/06/2009
Last updated
05/06/2009
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