Individual
CLARICE R GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
10800 S PEORIA ST, CHICAGO, IL 60643-3832
(773) 619-3998
Mailing address
10800 S PEORIA ST, CHICAGO, IL 60643-3832
(773) 619-3998
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Enumeration date
07/19/2018
Last updated
07/19/2018
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