Individual
JUAN MANUEL DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
3703 W LAKE AVE STE 200, GLENVIEW, IL 60026-1266
(847) 998-1188
Mailing address
3717 ELMWOOD AVE, BERWYN, IL 60402-4039
(708) 788-8373
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160004237
IL
Other
Enumeration date
08/17/2008
Last updated
08/17/2008
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