Individual
MR. BRYAN DE ROSAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
5130 W JACKSON BLVD, CHICAGO, IL 60644-4332
(773) 921-8000
Mailing address
4828 N NOTTINGHAM AVE, CHICAGO, IL 60656-3825
(312) 420-9354
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.005948
IL
Other
Enumeration date
02/25/2014
Last updated
02/25/2014
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