Individual
ANNALISE DIVITO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1233 W ADAMS ST, CHICAGO, IL 60607-2801
(312) 241-1204
Mailing address
304 N LOOMIS ST, CHICAGO, IL 60607-1147
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146.016430
IL
Other
Enumeration date
08/16/2021
Last updated
03/13/2023
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