Individual
SOPHIA FELICIANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12216 W THOMAS CT, MOKENA, IL 60448-9435
(708) 645-4580
Mailing address
12216 W THOMAS CT, MOKENA, IL 60448-9435
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043.072024
IL
Other
Enumeration date
09/29/2016
Last updated
09/29/2016
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