Individual
MRS. EVELYN CARMEN MALLIARAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
5820 N NAGLE AVE, UNIT G., CHICAGO, IL 60646-5344
(773) 774-1990
(773) 792-8119
Mailing address
5820 N NAGLE AVE, UNIT G., CHICAGO, IL 60646-5344
(773) 774-1990
(773) 792-8119
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
56007460
IL
Other
Enumeration date
06/18/2006
Last updated
07/08/2007
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