Individual
MS. SALLY SUE WILSON GAMBLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DT
Contact information
Practice address
9649 W 55TH ST, COUNTRYSIDE, IL 60525
(708) 352-3580
(708) 352-2715
Mailing address
614 S WENONAH AVE, OAK PARK, IL 60304
(708) 386-6818
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
02/16/2007
Last updated
07/08/2007
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