Individual
MRS. LYNNISE R. BALLEW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
372 RISEN STAR LN, OSWEGO, IL 60543-4033
(630) 802-4720
(630) 554-7210
Mailing address
372 RISEN STAR LN, OSWEGO, IL 60543
(630) 802-4720
(630) 554-7210
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
056-006338
IL
Other
Enumeration date
04/03/2007
Last updated
02/26/2015
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