Provider Demographics
NPI:1003429820
Name:LATRONICA, ADRIENNE C
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:C
Last Name:LATRONICA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9865 CORDOBA CT APT 2B
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-3190
Mailing Address - Country:US
Mailing Address - Phone:630-926-5474
Mailing Address - Fax:
Practice Address - Street 1:9865 CORDOBA CT APT 2B
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-3190
Practice Address - Country:US
Practice Address - Phone:630-926-5474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-31
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist