Individual
JILLIAN WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
5541 WASHINGTON ST, DOWNERS GROVE, IL 60516-1328
(630) 776-0137
Mailing address
5541 WASHINGTON ST, DOWNERS GROVE, IL 60516-1328
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
02/11/2016
Last updated
02/11/2016
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