Individual
JESSICA CORA SAUCILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
401 W LAKE ST, NORTHLAKE, IL 60164-2435
(708) 384-8073
Mailing address
2931 S 10TH AVE, BROADVIEW, IL 60155-4829
(478) 973-1699
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
07/06/2012
Last updated
07/06/2012
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