Individual
JUDITH MICEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT/L,CHT
Contact information
Practice address
1256 W BOUGHTON RD, BOLINGBROOK, IL 60440-6568
(630) 378-9420
(630) 378-9169
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056-000410
IL
Other
Enumeration date
02/04/2014
Last updated
06/21/2024
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