Individual
THERESA CERVANTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1715 DEKALB AVE, SUITE 125, SYCAMORE, IL 60178-2736
(815) 991-5760
Mailing address
1715 DEKALB AVE, SUITE 125, SYCAMORE, IL 60178-2736
(815) 991-5760
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
160.002546
IL
Other
Enumeration date
08/08/2011
Last updated
08/08/2011
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