Individual
ALTAIRA GIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
3824 W 69TH ST, CHICAGO, IL 60629-4206
(773) 937-3076
Mailing address
3824 W 69TH ST, CHICAGO, IL 60629-4206
(773) 937-3076
Taxonomy
Speciality
Code
Description
License number
State
136A00000X
Registered Dietetic Technician
Primary
—
—
Other
Enumeration date
02/13/2020
Last updated
02/13/2020
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