Individual
RAEESA MAHMOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3913 TULIP ST, CRYSTAL LAKE, IL 60014-2329
(773) 603-8542
Mailing address
3913 TULIP ST, CRYSTAL LAKE, IL 60014-2329
(773) 603-8542
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
06/07/2019
Last updated
06/07/2019
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