Individual
EMILY RAYNE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSOT, OTR/L
Contact information
Practice address
5820 W IRVING PARK RD, CHICAGO, IL 60634-2616
(773) 685-8482
Mailing address
3723 W EDDY ST, CHICAGO, IL 60618-5021
(440) 679-1344
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.013090
IL
Other
Enumeration date
08/09/2019
Last updated
08/09/2019
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