Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 056.007398 | IL |
NPI | 1750699112 |
---|---|
Provider Name | Dawn Wilson |
First Address | Glenview, IL 60026-1301 |
Second Address | Glenview, IL 60026-1301 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2010 |
Last Update Date | 20/09/2010 |