Individual
JILL DZIEKAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1309 LESTER DR, MANTENO, IL 60950-9489
(708) 715-5681
(815) 469-7360
Mailing address
1309 LESTER DR, MANTENO, IL 60950-9489
(708) 715-5681
(815) 469-7360
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227015133
IL
Other
Enumeration date
04/06/2015
Last updated
04/06/2015
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