Individual
MR. BRIAN DOUGLAS GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.T.R/L
Contact information
Practice address
820 S DAMEN AVE, CHICAGO, IL 60612-3728
(312) 569-6392
Mailing address
820 S DAMEN AVE, CHICAGO, IL 60612-3728
(312) 569-6392
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.009153
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
056.009153
ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION
IL
01
—
277447
THE NATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY, INC.
—
Enumeration date
10/26/2010
Last updated
10/26/2010
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