Individual
MS. DIANA MABERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17314 BURR OAK LN, HAZEL CREST, IL 60429-1608
(708) 566-1196
(708) 335-2823
Mailing address
17314 BURR OAK LN, HAZEL CREST, IL 60429-1608
(708) 566-1519
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
13757
IL
Other
Enumeration date
04/27/2012
Last updated
04/27/2012
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