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Individual

KELLY RANDALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTD/OTR

Contact information

Practice address
1442 OLD SKOKIE VALLEY RD, HIGHLAND PARK, IL 60035-3032
(847) 748-8870
(847) 786-2156
Mailing address
PO BOX 416501, BOSTON, MA 02241-7594
(194) 294-4050
(631) 760-8306

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary

Other

Enumeration date
11/02/2021
Last updated
11/02/2021
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