Individual
PATRICIA DELAWARE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2133 W LEXINGTON ST, CHICAGO, IL 60612-3707
(312) 746-9106
(312) 746-6526
Mailing address
2133 W LEXINGTON ST, CHICAGO, IL 60612-3707
(312) 746-9106
(312) 746-6526
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
123
PUBLIC HEALTH AID
IL
Enumeration date
10/21/2010
Last updated
10/21/2010
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