Individual
MRS. MELISSA JAYNE BANEVICH-GLAROS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
19350 BOULDER RIDGE DR, MOKENA, IL 60448-8238
(708) 257-1009
Mailing address
19350 BOULDER RIDGE DR, MOKENA, IL 60448-8238
(708) 257-1009
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
05605261
IL
Other
Enumeration date
05/08/2012
Last updated
05/08/2012
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