Individual
MS. STARLYNDA YOUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
5853 S INDIANA AVE, CHICAGO, IL 60637-1309
(773) 752-4468
Mailing address
5853 S INDIANA AVE, CHICAGO, IL 60637-1309
(773) 752-4468
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
SY14151205P
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SY14151205P
OTR
IL
05
—
SY14151205P
—
IL
Enumeration date
03/27/2007
Last updated
07/09/2007
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