Individual
ELLYSON REED STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
830 S ADDISON AVE, VILLA PARK, IL 60181-2877
(630) 620-4433
Mailing address
3347 N OAKLEY AVE APT 203, CHICAGO, IL 60618-6229
(630) 827-9969
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056012733
IL
225XP0200X
Pediatric Occupational Therapist
056012733
IL
Other
Enumeration date
11/19/2018
Last updated
01/07/2023
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