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Individual

JAMES MENDOZA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2005 WASHINGTON ST, WAUKEGAN, IL 60085-5131
(847) 910-5059
(847) 623-5304
Mailing address
2005 WASHINGTON ST, WAUKEGAN, IL 60085-5131
(847) 910-5059
(847) 623-5304

Taxonomy

Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
IL

Other

Enumeration date
01/03/2014
Last updated
01/03/2014
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