Individual
UTICA J KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OWNER
Contact information
Practice address
2136 W 72ND ST, CHICAGO, IL 60636-3620
(630) 988-3657
Mailing address
2136 W 72ND ST, CHICAGO, IL 60636-3620
(630) 988-3657
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
09/15/2023
Last updated
09/15/2023
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