Individual
DEANNA V LIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
558 W 35TH ST, CHICAGO, IL 60616-3532
(773) 451-0200
(773) 451-0700
Mailing address
558 W 35TH ST, CHICAGO, IL 60616-3532
(773) 451-0200
(773) 451-0700
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070021865
IL
Other
Enumeration date
10/28/2015
Last updated
10/28/2015
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