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Individual

MISS PENNY EDOIMIOYA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
539 MERRILL AVE, CALUMET CITY, IL 60409-3108
(312) 806-0960
Mailing address
539 MERRILL AVE, CALUMET CITY, IL 60409-3108
(312) 806-0960

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
E35067255648
IL

Other

Enumeration date
06/03/2008
Last updated
06/03/2008
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Product
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  • Eligibility checks
  • EDI platform