Individual
ANTOINETTE BERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1867 N MAUD AVE, CHICAGO, IL 60614-4905
(312) 656-3290
Mailing address
1345 W 98TH PL, CHICAGO, IL 60643-1441
(773) 414-8212
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/13/2015
Last updated
05/13/2015
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