Individual
COLLETTE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
3400 S INDIANA AVE, CHICAGO, IL 60616-3841
(312) 842-5000
Mailing address
3400 S INDIANA AVE, CHICAGO, IL 60616-3841
(312) 842-5000
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057003281
IL
Other
Enumeration date
12/14/2011
Last updated
12/14/2011
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