Individual
RAVADEE INPHOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
3512 GREENWOOD AVE, WILMETTE, IL 60091-1010
(847) 251-1231
(847) 251-1231
Mailing address
3512 GREENWOOD AVE, WILMETTE, IL 60091-1010
(847) 251-1231
(847) 251-1231
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K25343
PHYSICAL THERAPIST
IL
Enumeration date
11/16/2006
Last updated
07/08/2007
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