Individual
JACQUELINE ANN LEECH I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6450 W 64TH PL, CHICAGO, IL 60638-7028
(312) 493-9034
Mailing address
6450 W 64TH PL, CHICAGO, IL 60638-7028
(312) 493-9034
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
IL
Other
Enumeration date
08/30/2019
Last updated
08/30/2019
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