Individual
MR. GERARD BALGOS SUSMENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
7434 NORTH HERMITAGE AVENUE #3B, CHICAGO, IL 60626-1639
(847) 951-0097
Mailing address
1326 W COLUMBIA AVE, CHICAGO, IL 60626-4326
(773) 490-6232
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.007.661
IL
Other
Enumeration date
04/09/2009
Last updated
09/14/2016
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