Individual
KATIE JANE INGRUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS OTR/L
Contact information
Practice address
3703 W LAKE AVE, GLENVIEW, IL 60026-5823
(847) 998-1188
Mailing address
2341 W CHARLESTON ST, APT 1, CHICAGO, IL 60647-3258
(815) 751-8667
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.008873
IL
Other
Enumeration date
10/16/2011
Last updated
10/17/2011
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