Individual
NYERERE WERT COBB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
805 WILLOW DR, CHICAGO HEIGHTS, IL 60411-2128
(708) 928-0780
Mailing address
805 WILLOW DR, CHICAGO HEIGHTS, IL 60411-2128
(708) 928-0780
Taxonomy
Speciality
Code
Description
License number
State
225XG0600X
Gerontology Occupational Therapist
Primary
056010473
IL
Other
Enumeration date
01/13/2016
Last updated
01/13/2016
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