Individual
MILDRED WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9343 S SANGAMON ST, CHICAGO, IL 60620-2734
(773) 699-4281
(773) 496-0909
Mailing address
9343 S SANGAMON ST, CHICAGO, IL 60620-2734
(773) 699-4281
(773) 496-0909
Taxonomy
Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
—
—
172A00000X
Driver
Primary
W300-6008-4709
IL
246Q00000X
Pathology Specialist/Technologist
—
—
374700000X
Technician
—
—
Other
Enumeration date
05/19/2018
Last updated
05/19/2018
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