Hyacinth Wallace P.T, DPT

NPI 1396147047 - Physical Therapist - 2251X0800X

NPI Details
NPI 1396147047
Gender Female
Enumeration Date 09/24/2014
Last Updated 03/05/2015
Entity Type Individual
Active Over 2 years ago
Practice Location
4008 N CICERO AVE
CHICAGO IL, 60641-1807, US
Phone (773) 481-0540
Fax
Business Location
205 W WACKER DR
SUITE 1020
CHICAGO IL, 60606-1216, US
Phone (312) 640-0329
Fax
Toxanomy
Taxonomy Code 2251X0800X
License State Illinois
License Number 070020939
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According to our database, Hyacinth Wallace P.T, DPT NPI is 1396147047, taxonomy code is 2251X0800X and license number is 070020939, license state is located at Illinois. Hyacinth Wallace P.T, DPT physically located at 4008 N Cicero Ave, Chicago IL, 60641-1807. NPI Number Hyacinth Wallace P.T, DPT has the Individual type.

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1396147047 NPI number is provided on an as is basis without warranty of any kind. 1396147047 is maintained by the National Plan & Provider Enumeration System. The contents of Hyacinth Wallace P.T, DPT are for informational purposes only.