Individual
ANTHONY LARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CHC
Contact information
Practice address
100 E CHICAGO ST STE 204, ELGIN, IL 60120-5548
(312) 768-3311
Mailing address
100 E CHICAGO ST STE 204, ELGIN, IL 60120-5548
(312) 768-3311
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
Primary
N1416329
IL
Other
Enumeration date
11/04/2024
Last updated
11/04/2024
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