Individual
JOANN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
3442 W 73RD PL, CHICAGO, IL 60629-3514
(773) 937-4222
(773) 937-4223
Mailing address
14720 ARTESIAN AVE, HARVEY, IL 60426-1363
(773) 206-7122
(773) 937-4223
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057002620
IL
Other
Enumeration date
08/13/2008
Last updated
08/13/2008
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