Organization
TRI-NUE THERAPY P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GWENDOLYB RENEE NORMAN OTR (OCCUPATIONAL THERAPIST)
(708) 755-4636
Entity
Organization
Contact information
Practice address
825 W FITZHENRY CT, GLENWOOD, IL 60425-1114
(708) 755-4636
(708) 755-4690
Mailing address
825 W FITZHENRY CT, GLENWOOD, IL 60425-1114
(708) 755-4636
(708) 755-4690
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
056.002741
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
023
—
IL
Enumeration date
10/14/2015
Last updated
10/14/2015
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