Individual
KRISTIN MARIE WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
4646 N MARINE DR, CHICAGO, IL 60640-5759
(773) 564-5748
(773) 564-5689
Mailing address
4646 N MARINE DR, CHICAGO, IL 60640-5759
(773) 564-5748
(773) 564-5689
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056007919
IL
Other
Enumeration date
09/27/2012
Last updated
09/27/2012
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