Individual
JALEEL MINOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11560 S KEDZIE AVE, MERRIONETTE PARK, IL 60803-4517
(708) 974-5800
Mailing address
11560 S KEDZIE AVE, MERRIONETTE PARK, IL 60803-4517
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
M56042292210
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
M56042292210
—
IL
Enumeration date
12/06/2021
Last updated
12/06/2021
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