Individual
MARY SELBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
691 PARTRIDGE DR, WEST CHICAGO, IL 60185-5916
(630) 779-3626
Mailing address
691 PARTRIDGE DR, WEST CHICAGO, IL 60185-5916
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
17-03593
KS
Other
Enumeration date
01/13/2020
Last updated
01/13/2020
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