Individual
JESSICA M STUCKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MOTR/L
Contact information
Practice address
301 CHICAGO AVE, 3NE, OAK PARK, IL 60302-2360
(217) 257-2474
Mailing address
5128 HANLEY RD, QUINCY, IL 62305-9571
(217) 257-2474
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.008272
IL
Other
Enumeration date
12/20/2011
Last updated
12/20/2011
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