Individual
EMILY CLYSDALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
420 W FRONTAGE RD STE 200, NORTHFIELD, IL 60093-3046
(847) 784-9115
Mailing address
365 N HALSTED ST APT 1314, CHICAGO, IL 60661-1375
(651) 308-7291
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
56014281
IL
Other
Enumeration date
09/10/2021
Last updated
09/10/2021
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