Individual
JESSE FOREST LANGILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
1509 S MICHIGAN AVE, CHICAGO, IL 60605-2802
(312) 431-0434
Mailing address
205 W WACKER DR, SUITE 1020, CHICAGO, IL 60606-1216
(312) 640-0329
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056008865
IL
225XH1200X
Hand Occupational Therapist
—
—
Other
Enumeration date
09/14/2009
Last updated
04/09/2014
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