Individual
EDIE MONCADA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
901 S AUSTIN BLVD, CHICAGO, IL 60644-5311
(773) 287-9181
Mailing address
901 S AUSTIN BLVD, CHICAGO, IL 60644-5311
(773) 287-9181
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160004833
IL
Other
Enumeration date
06/30/2014
Last updated
06/30/2014
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