Individual
MISS KATIE MARIE FOGARTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
345 E SUPERIOR ST, CHICAGO, IL 60611-2654
(312) 238-6171
Mailing address
3553 N PAULINA ST, UNIT G, CHICAGO, IL 60657-1226
(317) 258-5241
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
IL
Other
Enumeration date
11/14/2006
Last updated
07/08/2007
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