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1215586359
ALFRED RAYMOND ELLSWORTH
CHICAGO, IL
NPI
1215586359
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: IL 070024499)
Enumeration Date
2019-09-11
Last Update Date
2019-09-11
Business Address
ALFRED RAYMOND ELLSWORTH DPT
7315 W IRVING PARK RD
CHICAGO, IL 60634-3547
Phone number: 773-786-2340
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Mailing Address
ALFRED RAYMOND ELLSWORTH DPT
790 REMINGTON BLVD
BOLINGBROOK, IL 60440-4909
Phone number: 630-296-2223
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