Individual
ELSY CECILIA FUENTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
118 DES PLAINES AVE, FOREST PARK, IL 60130-1004
(708) 288-1807
Mailing address
118 DES PLAINES AVE, FOREST PARK, IL 60130-1004
(708) 288-1807
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
—
—
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
02/12/2015
Last updated
02/12/2015
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