Individual
GABRIELLE KIRK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
811 W EVERGREEN AVE, UNIT 404, CHICAGO, IL 60642-7113
(312) 242-1665
Mailing address
422 ASHBURY DR, HINSDALE, IL 60521-4991
(973) 270-6575
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056011812
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
920411749
UNITED HEALTH CARE
IL
Enumeration date
04/17/2017
Last updated
04/17/2017
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