Individual
EDWARD TIONGSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5701 N KIMBALL AVE, BSMT APT, CHICAGO, IL 60659-4522
(773) 540-6638
Mailing address
5701 N KIMBALL AVE, BSMT APT, CHICAGO, IL 60659-4522
(773) 540-6638
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057004410
IL
Other
Enumeration date
11/25/2015
Last updated
11/25/2015
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