Individual
JACK FORREST HOUSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5TH AVENUE & ROOSEVELT ROAD BUILDING 113, HINES, IL 60141
(708) 202-3628
Mailing address
1612 ROBERT LN, NAPERVILLE, IL 60564-7126
(630) 904-2478
Taxonomy
Speciality
Code
Description
License number
State
2255R0406X
Blind Rehabilitation Specialist/Technologist
Primary
—
—
Other
Enumeration date
04/16/2007
Last updated
07/08/2007
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