Individual
MARY FAULKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
310 N LOOMIS ST, CHICAGO, IL 60607-1147
(312) 733-0883
Mailing address
310 N LOOMIS ST, CHICAGO, IL 60607-1147
(312) 733-0883
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056011873
IL
Other
Enumeration date
03/28/2017
Last updated
03/28/2017
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