Individual
JACOB TIMOTHY ANHALT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1725 W HARRISON ST STE 440, CHICAGO, IL 60612-3836
(312) 563-2454
Mailing address
2624 BROOKSIDE LN APT 805, SCHAUMBURG, IL 60173-6333
(608) 338-4298
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.016355
IL
Other
Enumeration date
12/25/2024
Last updated
12/30/2024
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