Individual
CHARLOTTE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4619 N RAVENSWOOD AVE STE 300, CHICAGO, IL 60640-4579
(773) 697-7333
Mailing address
1120 S GROVE AVE, OAK PARK, IL 60304-1909
(708) 663-0531
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
056.016072
IL
Other
Enumeration date
07/13/2024
Last updated
07/13/2024
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