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Individual

MICHAJA LYNN PRENDERGAST

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1820 W WEBSTER AVE, 2, CHICAGO, IL 60614-2934
(810) 656-2863
Mailing address
2600 N HAMPDEN CT, K7, CHICAGO, IL 60614-4943
(810) 656-2863

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.008197
IL

Other

Enumeration date
09/29/2010
Last updated
09/29/2010
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