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Individual

NICOLE MCDONALD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
550 W FRONTAGE RD STE 2415, NORTHFIELD, IL 60093-1212
(847) 441-5593
Mailing address
3731 STATE ROUTE 15, FREEBURG, IL 62243-1907

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056005390
IL

Other

Enumeration date
04/24/2012
Last updated
04/24/2012
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