Individual
MRS. AEBA T PRINCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
80 BIESTERFIELD RD, ELK GROVE VILLAGE, IL 60007-3668
(800) 974-4378
(630) 515-1536
Mailing address
24014 W RENWICK RD UNIT 206, PLAINFIELD, IL 60544-8711
(800) 974-4378
(630) 515-1536
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070.013747
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070.013747
STATE OF ILLINOIS LICENSE
IL
Enumeration date
03/06/2007
Last updated
01/12/2024
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