Most Relevant Information
Provider Data
| NPI Number: | 1003372426 |
| Provider Name: | JESSICA GUZMAN COTA/L |
| Entity Type: | Individual |
| Taxonomy Code: | 224Z00000X |
| Specialty: | Occupational Therapy Assistant |
| License Number: | 057004993 |
Most Important Dates
| Enumeration Date: | 02/11/2019 |
| Last Updated: | 02/11/2019 |
Provider Practice Location
3156 S KOMENSKY AVE
CHICAGO
IL
606234913
Practice Location Phone/Fax
| Phone: | 7736984156 |
| Fax: |
Provider Mailing Location
66 W OAK ST
CHICAGO
IL
606107325
Provider Mailing Phone/Fax
| Phone: | 3127056700 |
| Fax: |