Individual
JACQUELINE LEESEBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
3815 E MAIN ST STE B, ST CHARLES, IL 60174-2488
(630) 584-7530
Mailing address
1029 LAKESIDE DR, WEST CHICAGO, IL 60185-5022
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.013355
IL
Other
Enumeration date
11/06/2019
Last updated
11/06/2019
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