Jose Carlos
Occupational Therapy Assistant in Chicago, IL. Individual provider (NPI-1).
NPI number1851601751
StatusActive
Last updated in NPPESOct 14, 2010
Details
- NPI
- 1851601751
- Entity type
- Individual (NPI-1)
- Name
- Jose Carlos
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 14, 2010
- Last updated
- Oct 14, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 224Z00000X | Occupational Therapy Assistant | 057.002854 | IL | Yes |
Practice location
2612 W Leland AveApt # 2
Chicago, IL 60625-2986
Phone 312-339-0653
Mailing address
2612 W Leland AveApt # 2
Chicago, IL 60625-2986
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