Individual
DIEGO CASILLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3000 DUNDEE RD STE 418, NORTHBROOK, IL 60062-2436
(847) 480-7833
Mailing address
25252 W NEWBERRY LN, LAKE VILLA, IL 60046-9124
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.006303
IL
Other
Enumeration date
08/29/2012
Last updated
08/29/2012
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