Individual
CORILISE MARIE WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3004 S PULASKI RD, CHICAGO, IL 60623-4458
(773) 512-5300
(773) 521-5305
Mailing address
318 SAUGANASH ST, PARK FOREST, IL 60466-2227
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
IL
Other
Enumeration date
02/22/2007
Last updated
07/08/2007
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