Individual
JIMI ORANGE III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
333 N LA GRANGE RD, LA GRANGE PARK, IL 60526-5646
(708) 745-5277
Mailing address
4356 S PRAIRIE AVE, CHICAGO, IL 60653-4795
(773) 368-7300
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
—
—
Other
Enumeration date
05/29/2015
Last updated
05/29/2015
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