Individual
AVIANA LYS VALDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7421 MADISON ST, FOREST PARK, IL 60130-1575
(847) 909-1490
Mailing address
7421 MADISON ST, FOREST PARK, IL 60130-1575
(847) 909-1490
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056014265
IL
Other
Enumeration date
07/29/2021
Last updated
07/29/2021
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