JOSE CARLOS

CHICAGO, IL
NPI1851601751
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy224Z00000X Occupational Therapy Assistant
(Licence: IL  057.002854)
Enumeration Date2010-10-14
Last Update Date2010-10-14
Business Address
-- JOSE CARLOS
2612 W LELAND AVE APT # 2
CHICAGO, IL 60625-2986
Phone number: 312-339-0653
Mailing Address
-- JOSE CARLOS
2612 W LELAND AVE APT # 2
CHICAGO, IL 60625-2986
Phone number: