Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 056.002664 | IL |
NPI | 1023360278 |
---|---|
Provider Name | Ms. Joyce Antoinette Westfall |
First Address | Melrose Park, IL 60160-4039 |
Second Address | Melrose Park, IL 60160-4138 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2012 |
Last Update Date | 12/10/2012 |