Individual
LORI LYNN SPENCER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
141 W JACKSON BLVD, SUITE A 20, CHICAGO, IL 60604-2929
(312) 636-0440
Mailing address
141 W JACKSON BLVD, SUITE A 20, CHICAGO, IL 60604-2929
(312) 636-0440
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227-003030
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
227-003030
IL LICENSE
IL
Enumeration date
05/05/2008
Last updated
05/12/2009
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