Individual
SARA E PORTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
621 N DRAKE AVE, CHICAGO, IL 60624-1360
(312) 919-6814
Mailing address
621 N DRAKE AVE, CHICAGO, IL 60624-1360
(312) 919-6814
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
04/02/2019
Last updated
04/02/2019
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