Individual
VIVIAN MEDRANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
707 LAKE COOK RD STE 312, DEERFIELD, IL 60015-4933
(877) 486-4140
Mailing address
3443 S LEAVITT ST, CHICAGO, IL 60608-6020
(815) 764-3883
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057006126
IL
Other
Enumeration date
11/22/2024
Last updated
11/22/2024
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