Individual
ELISABETH DE AVILA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
7000 N MCCORMICK BLVD, LINCOLNWOOD, IL 60712-2726
(847) 673-7166
Mailing address
128 E STATE ST, KENNETT SQUARE, PA 19348-3172
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.010423
IL
Other
Enumeration date
02/26/2014
Last updated
02/26/2014
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