Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 070.022016 | IL |
NPI | 1003263278 |
---|---|
Provider Name | Eunice Sison |
First Address | Glenview, IL 60026-1266 |
Second Address | Glenview, IL 60026-1266 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2016 |
Last Update Date | 18/05/2016 |