Individual
MR. SIEGFRED T. CELIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1820 OAK PARK DRIVE, CHAMPAIGN, IL 61822
(217) 721-4420
Mailing address
1820 OAK PARK DR, CHAMPAIGN, IL 61822-5275
(217) 721-4420
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.003304
IL
Other
Enumeration date
10/12/2018
Last updated
10/12/2018
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