Individual
MR. BRAD A WILDI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MOT OTR/L
Contact information
Practice address
599 GROSVENER LN, ELK GROVE VILLAGE, IL 60007-4277
(847) 409-4869
Mailing address
599 GROSVENER LN, ELK GROVE VILLAGE, IL 60007-4277
(847) 409-4869
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.006087
IL
225X00000X
Occupational Therapist
9333
CA
Other
Enumeration date
05/24/2012
Last updated
05/24/2012
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