Individual
JESUS LUCERO TOVAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4433 TOUHY AVE, CHICAGO, IL 60647
(877) 486-1440
Mailing address
950 LEE ST STE 210, DES PLAINES, IL 60016-6574
(224) 521-1192
Taxonomy
Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
RBT-20-147311
IL
Other
Enumeration date
12/11/2020
Last updated
12/11/2020
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