Individual
JASMINE JANE GILLIAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
2211 N OAK PARK AVE, CHICAGO, IL 60707-3351
(773) 385-5875
(773) 385-5851
Mailing address
2211 N OAK PARK AVE, CHICAGO, IL 60707-3351
(773) 385-5875
(773) 385-5851
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
056.007550
IL
Other
Enumeration date
03/01/2011
Last updated
03/01/2011
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