Individual
LAURA JEAN CORRAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5841 S MARYLAND AVE, CHICAGO, IL 60637-1447
(773) 702-1220
Mailing address
1509 CLUB DR, GLENDALE HEIGHTS, IL 60139-3679
(404) 695-1867
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
085003798
IL
Other
Enumeration date
11/09/2006
Last updated
02/28/2017
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