Individual
EDWARD O'TOOLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
1865 E BELVIDERE RD, GRAYSLAKE, IL 60030-2218
(847) 796-0848
Mailing address
4740 N LAPORTE AVE, CHICAGO, IL 60630-3801
(773) 655-0627
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057004741
IL
Other
Enumeration date
12/06/2019
Last updated
12/06/2019
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