Individual
KARLA JOHAN AVILA-POLANCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3665 N BROADWAY ST, CHICAGO, IL 60613-4567
(773) 496-4433
Mailing address
4417 N CENTRAL PARK AVE APT 2F, CHICAGO, IL 60625-5968
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/28/2023
Last updated
03/28/2023
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