Individual
JAILENE QUIROZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6419 W 87TH ST, OAK LAWN, IL 60453-1048
(708) 634-0821
Mailing address
8500 MANSFIELD AVE, BURBANK, IL 60459-2535
(708) 735-3254
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
IL
Other
Enumeration date
11/29/2022
Last updated
11/29/2022
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