Individual
CORRINE DORITY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5029 W SUPERIOR ST, CHICAGO, IL 60644-1213
(312) 918-5306
Mailing address
5029 W SUPERIOR ST, CHICAGO, IL 60644-1213
(312) 918-5306
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
03/02/2021
Last updated
03/02/2021
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