Individual
CAMERON BALOG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
6700 S KEATING AVE, CHICAGO, IL 60629-5660
(773) 582-2888
Mailing address
1101 S STATE ST APT 1100, CHICAGO, IL 60605-3185
(219) 308-4876
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.016241
IL
Other
Enumeration date
10/15/2024
Last updated
10/15/2024
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