Individual
KELLY MARIE GAMBLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5201 WALNUT AVENUE, STE 4, DOWNERS GROVE, IL 60515-4025
(630) 964-4707
(630) 964-4797
Mailing address
1850 HEATHER GLEN DR, NEW LENOX, IL 60451-9719
(815) 463-8471
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
05600877
IL
Other
Enumeration date
08/07/2007
Last updated
08/01/2011
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