Individual
MYLA MONIQUE GILLIAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2425 E 71ST ST, CHICAGO, IL 60649-2612
(773) 721-5000
Mailing address
16400 HILLCREST DR, TINLEY PARK, IL 60477-8242
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056007465
IL
Other
Enumeration date
12/20/2011
Last updated
12/20/2011
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