Individual
GISELLE CAZARES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
5752 S TRUMBULL AVE, CHICAGO, IL 60629-3120
(773) 368-3012
Mailing address
5752 S TRUMBULL AVE, CHICAGO, IL 60629-3120
(773) 368-3012
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.005501
IL
Other
Enumeration date
03/07/2021
Last updated
03/07/2021
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