Individual
GRACE ELIZABETH BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1725 W HARRISON ST STE 440, CHICAGO, IL 60612-3836
(312) 563-2454
Mailing address
1035 W MONROE ST UNIT 1, CHICAGO, IL 60607-2792
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070029551
IL
Other
Enumeration date
10/13/2025
Last updated
10/13/2025
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