Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | IL |
NPI | 1003905340 |
---|---|
Provider Name | Rhella Doletina |
First Address | Chicago, IL 60602-1708 |
Second Address | Chicago, IL 60602-1708 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2006 |
Last Update Date | 08/07/2007 |