Individual
MRS. THERESA MARIE MCCOLLOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
17800 KEDZIE AVE, HAZEL CREST, IL 60429-2029
(708) 213-3829
(708) 422-1812
Mailing address
17800 KEDZIE AVE, HAZEL CREST, IL 60429-2029
(708) 213-3825
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160005041
IL
Other
Enumeration date
11/03/2008
Last updated
02/26/2022
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