Individual
MICHAEL PALENCIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
16536 MANCHESTER ST, TINLEY PARK, IL 60477
(708) 217-7405
Mailing address
64 CHANDON, LAGUNA NIGUEL, CA 92677-5727
(708) 217-7405
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
12/04/2015
Last updated
07/28/2018
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