Individual
MR. JUAN CARLO CAPIRAL CALVADORES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
5946 N MILWAUKEE AVE, CHICAGO, IL 60646-5424
(773) 775-6637
(773) 775-6638
Mailing address
5946 N MILWAUKEE AVE, CHICAGO, IL 60646-5424
(773) 775-6637
(773) 775-6638
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056-008637
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
056-008637
LICENSE NUMBER
IL
Enumeration date
07/19/2011
Last updated
07/19/2011
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