Individual
AUDRA CHAFONE PROWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3332 S 60TH CT, CICERO, IL 60804-3712
(708) 749-7470
Mailing address
3332 S 60TH CT, CICERO, IL 60804-3712
(708) 749-7470
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
03/18/2019
Last updated
04/15/2019
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