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Organization

BEGINNERS DEPOOT ECE CONSULTING

Active
Other names
Tywanda Jiles
Organization subpart
No

Provider details

NPI number
Authorized official
DR. TYWANDA M JILES EDD, DT (EXECUTIVE DIRECTOR)
(773) 710-6897
Entity
Organization

Contact information

Practice address
346 W 113TH ST, CHICAGO, IL 60628-4137
(773) 495-5152
Mailing address
346 W 113TH ST, CHICAGO, IL 60628-4137
(773) 495-5152

Taxonomy

Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
TJ35590103P
IL

Other

Enumeration date
09/16/2011
Last updated
09/16/2011
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