Individual
KIMBERLY WADDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
345 E. SUPERIOR ST., CHICAGO, IL 60611-2654
(312) 238-1000
Mailing address
RR1 BOX 154, STRONGHURST, IL 61480
(309) 221-3373
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056009180
IL
Other
Enumeration date
10/22/2010
Last updated
10/22/2010
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