Individual
DASHARAY EPTING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1115 W GARFIELD BLVD, CHICAGO, IL 60621-1528
(515) 305-7910
Mailing address
1115 W GARFIELD BLVD, CHICAGO, IL 60621-1528
(515) 305-7910
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
298837
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
85-0921247
IRS
IL
Enumeration date
05/20/2020
Last updated
05/20/2020
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