Individual
KIMBERLY A BEALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
1031 SOUTHGATE RD, NEW LENOX, IL 60451-2675
(708) 253-7363
Mailing address
1031 SOUTHGATE RD, NEW LENOX, IL 60451-2675
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056010043
IL
225X00000X
Occupational Therapist
31005442A
IN
Other
Enumeration date
02/28/2013
Last updated
02/28/2013
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