Individual
ANNE KRISTINE VITAL AVINANTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
3311 S MICHIGAN AVE, CHICAGO, IL 60616-3817
(773) 314-6403
Mailing address
6700 S OGLESBY AVE, APT 307, CHICAGO, IL 60649-1301
(773) 314-6403
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070.017603
IL
Other
Enumeration date
07/12/2012
Last updated
07/12/2012
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