Organization
JACOB LEDESMA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACOB DANIEL LEDESMA PT, DPT (OWNER/PHYSICAL THERAPIST)
(815) 295-4320
Entity
Organization
Contact information
Practice address
588 WILLIAM R LATHAM SENIOR DRIVE, STE 5, BOURBONNAIS, IL 60914
(815) 937-0446
Mailing address
588 WILLIAM R LATHAM SENIOR DRIVE, STE 5, BOURBONNAIS, IL 60914
(815) 937-0446
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
03/30/2021
Last updated
03/30/2021
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