Individual
STACEY ELIZABETH HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
1657 W CORTLAND ST, CHICAGO, IL 60622-1119
(847) 486-4140
Mailing address
950 LEE ST STE 210, DES PLAINES, IL 60016-6574
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Enumeration date
08/29/2017
Last updated
08/29/2017
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