NPI 1922407949

Deavolon Cotton

Practitioner Driver Homewood, IL

Practice location

Address: 831 Maple Ave STE 128, Homewood, IL 60430-2031
Phone: (773) 209-8081

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X

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Registry record

NPI: 1922407949
Entity type: Individual
Sex (as registered): Male
NPI issued: 14 Aug 2014
Record last updated: 14 Aug 2014

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.