Individual
MR. JESUS JOEL GULOY MANAGUELOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
5946 N MILWAUKEE AVE, CHICAGO, IL 60646-5424
(773) 775-6637
(773) 775-6638
Mailing address
5946 N MILWAUKEE AVE, CHICAGO, IL 60646-5424
(773) 775-6637
(773) 775-6638
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056008180
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
056.008180
LICENSE
IL
Enumeration date
06/04/2008
Last updated
10/20/2016
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