SearchIllinois224Z00000X

Theresa Banzuela, COTA/L

NPI 1205317567 · on the registry since 2018 · sole proprietor

Practice

Address
5320 W Fletcher St
Chicago, IL 60641
Phone
(773) 971-3352

Registry record

Primary taxonomy
224Z00000X
224Z00000X
Licence states on file
IL
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2018-08-24

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois