Individual
MRS. MARIA NESSAN VENERABLE LOBOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2006 EVANS AVE, LOVES PARK, IL 61111-3235
(847) 630-9010
Mailing address
4141 N ROCKTON AVE, ROCKFORD, IL 61103-1524
(815) 316-1519
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1600074013
IL
Other
Enumeration date
08/30/2021
Last updated
08/30/2021
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