Individual
JAZMINE SHAYNIKA MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
3633 BREAKERS DR, OLYMPIA FIELDS, IL 60461-1054
(708) 747-3333
Mailing address
134 MASON ST, CALUMET CITY, IL 60409-5220
(708) 351-3021
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.012705
IL
Other
Enumeration date
11/16/2018
Last updated
11/16/2018
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