Individual
MEAGAN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1600 W 13TH ST, CHICAGO, IL 60608-1304
(312) 243-5582
Mailing address
909 W CORNELIA AVE APT 2S, CHICAGO, IL 60657-1787
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.013246
IL
Other
Enumeration date
01/31/2020
Last updated
01/31/2020
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