Individual
CHANTAL GULOY MANAGUELO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3703 WEST LAKE,SUITE 200, GLENVIEW, IL 60026-1223
(847) 998-1188
Mailing address
5235 W MONTROSE AVE, CHICAGO, IL 60641-1418
(773) 685-4908
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070.015333
IL
Other
Enumeration date
02/12/2009
Last updated
02/12/2009
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