Individual
MARY BANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
900 RAND RD STE 110, DES PLAINES, IL 60016-2359
(847) 954-7646
(847) 954-7648
Mailing address
900 RAND RD STE 300, DES PLAINES, IL 60016-2359
(847) 324-3976
(847) 929-1154
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056-013999
IL
Other
Enumeration date
04/28/2021
Last updated
04/28/2021
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