Individual
MICHELLE MARIE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
540 N STATE ST APT 2605, CHICAGO, IL 60654-7236
(630) 418-2282
Mailing address
540 N STATE ST APT 2605, CHICAGO, IL 60654-7236
(630) 418-2282
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056012888
IL
Other
Enumeration date
04/29/2019
Last updated
04/29/2019
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