Individual
JESUS ROMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
6006 159TH ST BLDG A, OAK FOREST, IL 60452-2904
(708) 535-9242
Mailing address
6006 159TH ST BLDG A, OAK FOREST, IL 60452-2904
(708) 535-9242
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.006812
IL
Other
Enumeration date
05/19/2016
Last updated
05/19/2016
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