Individual
DR. JERRY MARK OTOOLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
24402 W LOCKPORT ST STE 215, PLAINFIELD, IL 60544-4204
(630) 621-5824
Mailing address
12816 TIMBER WOOD CIR, PLAINFIELD, IL 60585-2974
(240) 449-5170
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
071006413
IL
Other
Enumeration date
07/16/2020
Last updated
08/29/2024
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