Individual
CARLOS MIYASATO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
550 W SAINT CHARLES RD, ELMHURST, IL 60126-3038
(815) 469-1500
Mailing address
730 CARPENTER AVE APT 2N, OAK PARK, IL 60304-1139
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-24-78664
IL
Other
Enumeration date
05/14/2018
Last updated
01/02/2025
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