Individual
JASON DAVID MAHILO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MOTR/L
Contact information
Practice address
7250 ARTHUR BLVD, MERRILLVILLE, IN 46410-3766
(440) 213-0106
(440) 649-7446
Mailing address
4350 N BROADWAY ST APT 402, CHICAGO, IL 60613-4854
(440) 213-0106
(440) 649-7446
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
056.010065
IL
225X00000X
Occupational Therapist
Primary
31005875A
IN
Other
Enumeration date
08/21/2013
Last updated
09/09/2015
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