Individual
SHANIA ENRIQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7421 MADISON ST, FOREST PARK, IL 60130-1575
(708) 527-0717
Mailing address
7421 MADISON ST, FOREST PARK, IL 60130-1575
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
056.015109
IL
Other
Enumeration date
09/15/2022
Last updated
09/15/2022
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