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Individual

VIVIAN ELISE NASH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4902 S CHAMPLAIN AVE, CHICAGO, IL 60615-2509
(312) 978-7549
Mailing address
8812 S EUCLID AVE, CHICAGO, IL 60617-2907

Taxonomy

Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary

Other

Enumeration date
04/18/2026
Last updated
04/18/2026
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