Individual
JORDAN MARIE FREDRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9131 SANDPIPER CT, ORLAND PARK, IL 60462-3274
(708) 465-8391
Mailing address
9131 SANDPIPER CT, ORLAND PARK, IL 60462-3274
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057004408
IL
Other
Enumeration date
04/21/2020
Last updated
04/21/2020
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