Individual
JAX ANTHONY MOSQUERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1740 RIDGE AVE, EVANSTON, IL 60201-5918
(847) 558-7327
Mailing address
5452 N ASHLAND AVE # 2, CHICAGO, IL 60640-1101
(773) 332-8891
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/21/2025
Last updated
08/21/2025
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