Individual
MRS. KATHLEEN TERESE QUACKENBUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2014 W 22ND PL, UNIT 1, CHICAGO, IL 60608-4114
(630) 429-6869
Mailing address
2014 W 22ND PL, UNIT 1, CHICAGO, IL 60608-4114
(630) 429-6869
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
B56351887866
IL
Other
Enumeration date
01/08/2015
Last updated
01/08/2015
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