Individual
JOSE RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5705 WILLOW SPRINGS RD, COUNTRYSIDE, IL 60525-3478
(312) 965-2997
Mailing address
5705 WILLOW SPRINGS RD, COUNTRYSIDE, IL 60525-3478
(312) 965-2997
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/21/2022
Last updated
06/21/2022
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