Most Relevant Information
Provider Data
| NPI Number: | 1003443417 |
| Provider Name: | MYRTLE RYCRAW |
| Entity Type: | Individual |
| Taxonomy Code: | 172V00000X |
| Specialty: | Community Health Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/25/2020 |
| Last Updated: | 03/25/2020 |
Provider Practice Location
4800 SOUTHWICK DR STE 300
MATTESON
IL
604432235
Practice Location Phone/Fax
| Phone: | 7087472655 |
| Fax: |
Provider Mailing Location
4800 SOUTHWICK DR STE 300
MATTESON
IL
604432235
Provider Mailing Phone/Fax
| Phone: | 7087472655 |
| Fax: |