FANOR BENAVIDEZ

LA GRANGE, IL
NPI1316793011
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy224Z00000X Occupational Therapy Assistant
(Licence: IL  057.005735)
Enumeration Date2024-04-24
Last Update Date2024-04-24
Business Address
FANOR BENAVIDEZ
35 SHAWMUT AVE
LA GRANGE, IL 60525-8648
Phone number: 708-206-9899
Mailing Address
FANOR BENAVIDEZ
2824 HARVEY AVE
BERWYN, IL 60402-2705
Phone number: 773-510-5182
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