Individual
MS. LIEZEL GRANZON TAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
3919 W FOSTER AVE, CHICAGO, IL 60625-6056
(773) 588-9500
Mailing address
2629 W HOWARD ST, CHICAGO, IL 60645
(773) 505-8091
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
04/24/2019
Last updated
04/24/2019
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