Individual
MRS. ZANTRAQUILLA Z MADKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7829 SOUTH WABASH, CHICAGO, IL 60619
(855) 924-9700
(312) 809-9109
Mailing address
7829 SOUTH WABASH, CHICAGO, IL 60619
(855) 924-9700
(312) 809-9109
Taxonomy
Speciality
Code
Description
License number
State
347E00000X
Transportation Broker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
611933984
—
IL
Enumeration date
12/18/2018
Last updated
04/05/2020
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