Individual
JILVALLA CARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4637 S CALUMET AVE APT 1S, CHICAGO, IL 60653-4062
(773) 425-7728
Mailing address
4637 S CALUMET AVE APT 1S, CHICAGO, IL 60653-4062
(773) 425-7728
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
IL
Other
Enumeration date
07/09/2024
Last updated
07/09/2024
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