Individual
MS. ROY JEAN TILLMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2056 E 73RD ST, CHICAGO, IL 60649-2904
(773) 218-2165
Mailing address
2056 E 73RD ST, CHICAGO, IL 60649-2904
(773) 218-2165
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
1981534
IL
222Q00000X
Developmental Therapist
Primary
1981536
IL
Other
Enumeration date
10/09/2012
Last updated
10/09/2012
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