NPI 1063968311

Deneen Minor

Practitioner Driver Chicago, IL

Practice location

Address: 6827 S. Champlain Ave., Chicago, IL 60637
Phone: (312) 805-6355
Mailing address: 6827 S Champlain Ave, Chicago, IL 60637-4114

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X Licence M560-1728-9741 (IL)

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Registry record

NPI: 1063968311
Entity type: Individual
Sex (as registered): Female
NPI issued: 28 Aug 2016
Record last updated: 28 Aug 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.