Individual
FREDERICK ITALIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3703 W LAKE AVE, SUITE 200, GLENVIEW, IL 60026-5823
(847) 998-1188
Mailing address
1611 CINDY LN, SANDWICH, IL 60548
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070.007585
IL
Other
Enumeration date
06/30/2010
Last updated
06/30/2010
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