Blackmon, Juanita

Blackmon, Juanita is an sole proprietor health care provider with primary practice located at 5904 S Kedzie Ave Apt 303 , Chicago IL 60629-3216. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist, which is considered as her primary health care specialty. Blackmon, Juanita can be contacted via phone (312) 342-9118.

Contact Information

Primary practice address
5904 S Kedzie Ave Apt 303 Chicago IL 60629-3216
Phone: (312) 342-9118
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist 222Q00000X

Profile Details

NPI number 1033764485
LBN Legal business name Blackmon, Juanita
Credentials MS
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 2nd, 2019
Last updated Aug 2nd, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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