Individual
ALYSSA MARIE VANDERAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1806 S HIGHLAND AVE, LOMBARD, IL 60148-4938
(312) 604-3740
Mailing address
851 W CORNELIA AVE, CHICAGO, IL 60657-1723
(608) 778-7263
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160008591
IL
Other
Enumeration date
05/15/2020
Last updated
05/15/2020
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