Individual
JACOB RICCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1620 W HARRISON ST, CHICAGO, IL 60612-3801
(888) 352-7874
Mailing address
1922 W OGDEN AVE UNIT 1413, CHICAGO, IL 60612-5586
(480) 358-8312
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/24/2024
Last updated
05/24/2024
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