Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 056013441 | IL |
NPI | 1336748441 |
---|---|
Provider Name | Steven M Deleon |
First Address | Chicago, IL 60614-3772 |
Second Address | Schaumburg, IL 60194-3464 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2020 |
Last Update Date | 20/10/2020 |