Individual
STEFANIE DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2801 S LAWNDALE AVE, CHICAGO, IL 60623-4547
(773) 521-5300
Mailing address
5159 W MEDILL AVE, CHICAGO, IL 60639-3111
(773) 218-0658
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160008723
IL
Other
Enumeration date
09/23/2019
Last updated
09/23/2019
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