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Individual

ELISA MARIE DE JONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
C.O.

Contact information

Practice address
2300 N CHILDRENS PLZ, BOX #46, CHICAGO, IL 60614-3363
(773) 327-1022
(773) 327-1054
Mailing address
2300 N CHILDRENS PLZ, BOX #46, CHICAGO, IL 60614-3363
(773) 327-1022
(773) 327-1054

Taxonomy

Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary

Other

Enumeration date
11/01/2010
Last updated
11/01/2010
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