Individual
LANETTE NEWMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14411 S LASALLE ST, RIVERDALE, IL 60827
(708) 953-0546
Mailing address
14411 S LASALLE ST, RIVERDALE, IL 60827
(708) 953-0546
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
09/22/2016
Last updated
09/22/2016
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