Individual
CARLOS ALBERTO PONCE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3200 GRANT ST, EVANSTON, IL 60201-1903
(847) 570-3422
Mailing address
10055 FRONTAGE RD UNIT A, SKOKIE, IL 60077-1058
(773) 988-7302
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.010389
IL
Other
Enumeration date
04/22/2025
Last updated
04/22/2025
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