Individual
COREY MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4528 S EVANS AVE, CHICAGO, IL 60653-3521
(312) 856-7251
Mailing address
4528 S EVANS AVE, CHICAGO, IL 60653-3521
(312) 856-7251
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
—
—
Other
Enumeration date
02/10/2017
Last updated
02/10/2017
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