Individual
JEIRY A ESCOBAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4425 N SAINT LOUIS AVE, CHICAGO, IL 60625-5423
(773) 329-6877
Mailing address
4425 N SAINT LOUIS AVE, CHICAGO, IL 60625-5423
(773) 329-6877
Taxonomy
Speciality
Code
Description
License number
State
171R00000X
Interpreter
Primary
E21642183032
IL
Other
Enumeration date
04/05/2010
Last updated
04/05/2010
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