Individual
JOLENE GEMBARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
910 GREY AVE, EVANSTON, IL 60202-1511
(847) 890-1893
Mailing address
910 GREY AVE, EVANSTON, IL 60202-1511
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.003631
IL
Other
Enumeration date
12/30/2014
Last updated
12/30/2014
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