Individual
MRS. GEMMALYN DE JESUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
6801 HIGH GROVE BLVD, BURR RIDGE, IL 60527-7585
(630) 424-0932
Mailing address
5840 PERSHING AVE, DOWNERS GROVE, IL 60516-1133
(630) 810-1054
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160003219
IL
Other
Enumeration date
06/09/2008
Last updated
06/09/2008
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