Individual
JULIE GROBBELAAR FERNANDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
2615 HARRISON ST, BELLWOOD, IL 60104-2450
(708) 493-0199
(708) 493-9683
Mailing address
2615 HARRISON ST, BELLWOOD, IL 60104-2450
(708) 493-0199
(708) 493-9683
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
056008894
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
056008894
LICENSE
IL
Enumeration date
11/01/2010
Last updated
11/01/2010
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