Individual
MRS. RIA CONTREDAS MALONZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
500 MCHENRY RD, BUFFALO GROVE, IL 60089-1705
(847) 537-3445
Mailing address
500 MCHENRY RD, BUFFALO GROVE, IL 60089-1705
(847) 537-3445
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
070.019562
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M452-7237-7622
DRIVER'S LICENSE
IL
Enumeration date
07/08/2014
Last updated
12/16/2017
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