Individual
TIA STRONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9413 S VERNON AVE, CHICAGO, IL 60619-7407
(312) 870-0715
Mailing address
9413 S VERNON AVE, CHICAGO, IL 60619-7407
(312) 870-0715
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
08/20/2020
Last updated
08/20/2020
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