Individual
JODI GAC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11 N ROSELLE RD, ROSELLE, IL 60172-1581
(630) 893-5601
(630) 893-5602
Mailing address
11 N ROSELLE RD, ROSELLE, IL 60172-1581
(630) 893-5601
(630) 893-5602
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.001741
IL
Other
Enumeration date
05/14/2015
Last updated
05/14/2015
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