Individual
SAMANTHA MAO PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5040 N MARINE DR, APT A8, CHICAGO, IL 60640-3268
(773) 450-5910
Mailing address
5040 N MARINE DR, A8, CHICAGO, IL 60640-3268
(773) 450-5910
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
08/01/2008
Last updated
09/25/2009
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