Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 056001169 | IL |
NPI | 1033161252 |
---|---|
Provider Name | Ms. Estherlyn Maymon |
First Address | Chicago, IL 60612-3728 |
Second Address | Chicago, IL 60612-3728 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2006 |
Last Update Date | 30/06/2011 |