Individual
RAYCHAEL LANICE AYRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
313 GURLER ST APT 6, DEKALB, IL 60115-3661
(815) 748-8544
Mailing address
236 MCMILLAN CT UNIT 202, CORTLAND, IL 60112-4178
(815) 901-6815
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/30/2017
Last updated
06/30/2017
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