Individual provider · Type 1 NPI

Sandra Juel Black, L.M.T.

Massage Therapist · Chicago, IL

NPI number 1104206598 Active

Practice location

2052 N Cleveland Ave, Garden Suite
Chicago, IL 60614-4505

Call (773) 281-2225 Map

Fax (773) 281-2226

Mailing address

PO Box 371
Shell Rock, IA 50670-0371

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X227.005112 (IL)
Massage Therapist 225700000X006290 (IA)

Massage Therapist: An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

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About NPI 1104206598

Sandra Juel Black, L.M.T.'s National Provider Identifier is 1104206598, issued on Jun 1, 2015. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Chicago, IL. The record was last updated on Jun 1, 2015.