Individual
ELIZABETH FAYE PUTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
10300 VILLAGE CIR DR, PEACE VILLAGE, PALOS PARK, IL 60464
(708) 361-3683
Mailing address
14617 S ARBORETUM DRIVE, HOMER GLEN, IL 60491
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160007154
IL
Other
Enumeration date
04/11/2018
Last updated
04/11/2018
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