Individual
MARY OTTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3260 N LAKE SHORE DR APT 6B, CHICAGO, IL 60657-3914
(773) 816-0114
Mailing address
3260 N LAKE SHORE DR APT 6B, CHICAGO, IL 60657-3914
(773) 816-0114
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
347C00000X
Private Vehicle
Primary
—
—
Other
Enumeration date
05/23/2024
Last updated
05/23/2024
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