Individual
JELANI KEHINDE THORNTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
6000 N ALLEN ROAD, PEORIA, IL 61614-3294
(309) 691-1400
Mailing address
6000 N ALLEN ROAD, PEORIA, IL 61614-3294
(309) 691-1400
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056-007447
IL
Other
Enumeration date
02/21/2007
Last updated
12/31/2019
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