Organization
NOVA CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS TEKELA ROCHELLE SCOTT MPT (CLINICAL SUPERVISOR)
(773) 788-9374
Entity
Organization
Contact information
Practice address
5405 S HARLEM AVE, CHICAGO, IL 60638-2205
(773) 788-9374
(773) 788-9378
Mailing address
5405 S HARLEM AVE # 07, CHICAGO, IL 60638-2205
(773) 788-9374
(773) 788-9378
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
70012853
IL
Other
Enumeration date
11/30/2006
Last updated
08/22/2020
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