Individual
MS. JO ANNE MACZULSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR L
Contact information
Practice address
537 W ROSCOE ST, 2N, CHICAGO, IL 60657-3518
(773) 750-7497
(773) 281-6020
Mailing address
537 W ROSCOE ST, 2N, CHICAGO, IL 60657-3518
(773) 750-7497
(773) 281-6020
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
056000358
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1633586
BC/BS PIN
IL
Enumeration date
09/23/2006
Last updated
07/08/2007
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