Individual
MISS MARION FIDES RUIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5839 W 63RD ST, CHICAGO, IL 60638-5445
(872) 600-1689
Mailing address
5839 W 63RD ST, CHICAGO, IL 60638-5445
(872) 600-1689
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
019354
NY
225X00000X
Occupational Therapist
Primary
056011354
IL
Other
Enumeration date
01/30/2018
Last updated
01/09/2024
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