Individual
MINDY CISNEROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11033 S KILBOURN AVE, OAK LAWN, IL 60453-5734
(773) 885-0735
Mailing address
11033 S KILBOURN AVE, OAK LAWN, IL 60453-5734
(773) 885-0735
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7738850735
CELPHONENUMBER
IL
Enumeration date
06/04/2020
Last updated
06/04/2020
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