Individual
MRS. JESSICA LYNN ANTONIOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1304 RONZHEIMER AVE, ST CHARLES, IL 60174-4450
(331) 228-3874
Mailing address
1304 RONZHEIMER AVE, ST CHARLES, IL 60174-4450
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146011588
IL
Other
Enumeration date
09/01/2017
Last updated
09/01/2017
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