Individual
MRS. GWENDOLYN RENEE NORMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
15947 FINCH AVE, HARVEY, IL 60426-5217
(708) 333-7959
Mailing address
PO BOX 1394, HARVEY, IL 60426-7394
(708) 333-7959
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01636977
BLUE CROSS BLUE SHIELD
IL
Enumeration date
05/23/2007
Last updated
07/08/2007
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