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1003104324
JASON PETER SCHALLACK
MELROSE PARK, IL
NPI
1003104324
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2011-07-20
Last Update Date
2011-07-20
Business Address
Mr. JASON PETER SCHALLACK MFA
1414 MAIN ST
MELROSE PARK, IL 60160-3902
Phone number: 708-681-0073
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Mailing Address
Mr. JASON PETER SCHALLACK MFA
539 BELLEFORTE AVE
OAK PARK, IL 60302-1623
Phone number: 708-681-0073
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