Individual
HENNA TAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O
Contact information
Practice address
20201 CRAWFORD AVE, ATTN: POSTDOCTORAL EDUCATION, OLYMPIA FIELDS, IL 60461-1010
(708) 747-4000
Mailing address
5843 CAPULINA AVE, MORTON GROVE, IL 60053-3002
(847) 840-7491
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/09/2013
Last updated
03/09/2013
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