Individual
COURTNEY NEWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1823 W WABANSIA AVE, CHICAGO, IL 60622-1334
(815) 762-2140
Mailing address
1823 W WABANSIA AVE, CHICAGO, IL 60622-1334
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
222Q00000X
PROVIDER CONNECTIONS
IL
Enumeration date
06/04/2014
Last updated
06/04/2014
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