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Individual

JOSEPH ALBERT MENDOZA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MS, OTR/L

Contact information

Practice address
1740 W TAYLOR ST, C100, M/C 889, CHICAGO, IL 60612-7232
(312) 996-3700
Mailing address
1740 W TAYLOR ST, C100, M/C 889, CHICAGO, IL 60612-7232
(312) 996-3700

Taxonomy

Speciality
Code
Description
License number
State
225XN1300X
Neurorehabilitation Occupational Therapist
056.009192
IL
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
056.009192
IL

Other

Enumeration date
03/25/2013
Last updated
03/25/2013
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