Individual
MRS. KELLY CHASE WEGENER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
331 S LOMBARD AVE, OAK PARK, IL 60302-3523
(708) 917-7422
Mailing address
331 S LOMBARD AVE, OAK PARK, IL 60302-3523
(708) 917-7422
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
056-002673
IL
Other
Enumeration date
02/28/2009
Last updated
02/28/2009
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