Individual
MS. JODI LEE CARROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS OTR/L
Contact information
Practice address
1640 N WELLS ST, # 103, CHICAGO, IL 60614-6087
(231) 392-6420
Mailing address
3315 N WOLCOTT AVE, APT 2, CHICAGO, IL 60657-2020
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.009103
IL
Other
Enumeration date
05/05/2011
Last updated
05/05/2011
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