Ellen Wildman, | |
5239 N Clark St, 2nd Floor, Chicago, IL 60640-2122 | |
(773) 334-7440 | |
Not Available |
Full Name | Ellen Wildman |
---|---|
Gender | Female |
Speciality | Massage Therapist |
Location | 5239 N Clark St, Chicago, Illinois |
Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1679972863 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225700000X | Massage Therapist | 227.000470 (Illinois) | Primary |
Mailing Address | Practice Location Address |
---|---|
Ellen Wildman, 5239 N Clark St, 2nd Floor, Chicago, IL 60640-2122 Ph: (773) 334-7440 | Ellen Wildman, 5239 N Clark St, 2nd Floor, Chicago, IL 60640-2122 Ph: (773) 334-7440 |
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