Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 038012959 | IL |
NPI | 1225583529 |
---|---|
Provider Name | Leah Guidolin |
First Address | Bloomingdale, IL 60108-1363 |
Second Address | Naperville, IL 60563-2388 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2016 |
Last Update Date | 27/01/2017 |