Individual
MARY ELLEN STOYKOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
SHIRLEY RYAN ABILITY LAB, 355 E. ERIE ST., CHICAGO, IL 60611-2654
(312) 238-1000
Mailing address
355 E ERIE ST, CHICAGO, IL 60611-3167
(312) 238-1000
(312) 238-1229
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056003438
IL
225XN1300X
Neurorehabilitation Occupational Therapist
056003438
IL
Other
Enumeration date
11/07/2017
Last updated
11/07/2017
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