Individual
MR. JASON MICHAEL THAVENET
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MOT,OTR/L,CHT
Contact information
Practice address
825 S MILWAUKEE AVE, LIBERTYVILLE, IL 60048-3218
(847) 990-5350
(847) 549-6920
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.008146
IL
Other
Enumeration date
05/03/2012
Last updated
08/01/2023
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