SearchIllinois225X00000X

Revati Date

NPI 1538471792 · on the registry since 2010 · sole proprietor

Practice

Address
525 W Stratford Pl
Apt # 280
Chicago, IL 60657
Phone
(412) 867-1404

Registry record

Primary taxonomy
225X00000X
225X00000X
Licence states on file
IL
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2010-07-05

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois