Individual
DELORES MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8601 S STATE ST, CHICAGO, IL 60619-5614
(773) 744-9112
Mailing address
108 WEST 83RD ST., CHICAGO, IL 60620
(773) 744-9112
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.005891
IL
Other
Enumeration date
09/18/2012
Last updated
07/15/2014
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