Individual
JOHANA MACHUCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5758 S MARYLAND AVE, CHICAGO, IL 60637-1426
(312) 450-9308
Mailing address
5111 W BARRY AVE, CHICAGO, IL 60641-5048
(312) 450-9308
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
242007429
IL
Other
Enumeration date
08/03/2023
Last updated
08/29/2023
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