Individual
MIGUEL ANGEL REYES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
3917 W 69TH ST, CHICAGO, IL 60629-4225
(773) 559-5450
Mailing address
3917 W 69TH ST, CHICAGO, IL 60629-4225
(773) 559-5450
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057005361
IL
Other
Enumeration date
04/02/2020
Last updated
07/20/2020
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