Individual
JAIME NYSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14222 S BELL RD, HOMER GLEN, IL 60491-8122
(815) 469-1500
Mailing address
21863 BLUE BIRD LN, FRANKFORT, IL 60423-2292
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
04/22/2019
Last updated
11/29/2023
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