Individual
LOURDES DE LA ROSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M. ED
Contact information
Practice address
701 N KRAMER AVE, LOMBARD, IL 60148-1943
(630) 561-2075
Mailing address
120 FAIRLAWN DR, ROUND LAKE PARK, IL 60073-3111
(224) 770-0045
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
11/23/2020
Last updated
11/23/2020
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