Individual
MICHELLE TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3601 S HARLEM AVE, BERWYN, IL 60402-3219
(708) 749-4160
Mailing address
5100 W 96TH ST APT 230, OAK LAWN, IL 60453-3819
(610) 233-8183
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.013957
ID
Other
Enumeration date
01/25/2023
Last updated
01/25/2023
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