Individual
TAYLOR PARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
3040 N SOUTHPORT AVE APT 2R, CHICAGO, IL 60657-4249
(502) 542-9242
Mailing address
3040 N SOUTHPORT AVE APT 2R, CHICAGO, IL 60657-4249
(502) 542-9242
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
17-35802
KY
225XM0800X
Mental Health Occupational Therapist
Primary
—
IL
Other
Enumeration date
07/20/2018
Last updated
11/08/2022
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