Individual
KRISTINE LOUISE MADURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
4239 N OAK PARK AVE, CHICAGO, IL 60634-1410
(219) 614-8206
Mailing address
2415 NEW YORK AVE, WHITING, IN 46394-2145
(219) 614-8206
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057003716
IL
224Z00000X
Occupational Therapy Assistant
298567
IN
Other
Enumeration date
10/01/2019
Last updated
10/01/2019
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