Individual
MR. JORGE LUIS ROMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3100 S CENTRAL AVE, CICERO, IL 60804-3956
(708) 863-3803
Mailing address
3220 LOMBARD AVE, BERWYN, IL 60402-3517
(773) 574-8626
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
07/30/2018
Last updated
07/30/2018
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