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Individual

JACK LEANDER IMPERIAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
BT

Contact information

Practice address
3030 W SALT CREEK LN STE 350, ARLINGTON HEIGHTS, IL 60005-5000
(877) 486-4140
Mailing address
628 W. BOB-O-LINK RD., MOUNT PROSPECT, IL 60056
(224) 500-5955

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
IL

Other

Enumeration date
11/14/2023
Last updated
11/14/2023
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