Individual
MS. CHRISTY M OLOFSSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T., P.T.A.
Contact information
Practice address
10201 S WESTERN AVE, CHICAGO, IL 60643-1917
(773) 779-7273
(773) 779-7298
Mailing address
10201 S WESTERN AVE, CHICAGO, IL 60643-1917
(773) 779-7273
(773) 779-7298
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
160004410
IL
225X00000X
Occupational Therapist
Primary
056002420
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001618872
BLUE CROSS BLUE SHEILD
IL
Enumeration date
04/04/2007
Last updated
05/13/2010
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