Individual
JERI RUTH KONECKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA L
Contact information
Practice address
445 N WELLS ST, SUITE 303, CHICAGO, IL 60610-4579
(800) 494-9936
Mailing address
1589 CONDOR DR, MANTENO, IL 60950-3599
(815) 468-2079
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
IL
Other
Enumeration date
05/21/2007
Last updated
07/08/2007
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