Individual
MS. LATESHA MONAE CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT OTR/L
Contact information
Practice address
10201 S CICERO AVE, OAK LAWN, IL 60453-4098
(708) 232-8993
Mailing address
10201 S CICERO AVE STE F, OAK LAWN, IL 60453-4098
(708) 232-8993
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.010261
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LT54271113P
EARLY INTERVENTION
IL
Enumeration date
09/13/2013
Last updated
04/19/2022
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