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Individual

MR. TYRELL FUNKHOUSER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MS, OTR/L, CHT, MBA

Contact information

Practice address
737 N MICHIGAN AVE, 700, CHICAGO, IL 60611-2615
(312) 337-6960
Mailing address
737 N MICHIGAN AVE, 700, CHICAGO, IL 60611-2615

Taxonomy

Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
056006741
IL

Other

Enumeration date
06/26/2012
Last updated
06/26/2012
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