Individual
CAROLYN MARIE JANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3775 GRAND AVE, GURNEE, IL 60031-2909
(847) 623-6300
Mailing address
14500 TOWNE TRAIL, GREEN OAKS, IL 60048
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.002558
IL
Other
Enumeration date
06/26/2018
Last updated
06/26/2018
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