Individual
MR. MARCUS WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
1640 W ROOSEVELT RD, CHICAGO, IL 60608-1316
(312) 996-4921
Mailing address
1640 W ROOSEVELT RD OFC 408, CHICAGO, IL 60608-1316
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.004797
IL
Other
Enumeration date
10/29/2019
Last updated
10/29/2019
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