Individual
JATONA HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1256 W BOUGHTON RD, BOLINGBROOK, IL 60440-6568
(630) 378-9420
Mailing address
9057 S MARSHFIELD AVE, CHICAGO, IL 60620-5546
(773) 573-5297
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056015596
IL
Other
Enumeration date
09/05/2023
Last updated
09/07/2023
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