Individual
MS. CAROLYN WILKENS BLANK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
345 E SUPERIOR ST, CHICAGO, IL 60611-2654
(312) 238-3185
Mailing address
540 NW LOST SPRINGS TER STE 308, PORTLAND, OR 97229-6678
(773) 870-6876
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056006922
IL
Other
Enumeration date
10/24/2007
Last updated
09/24/2014
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