Individual
AMANDA JEAN MATHEWS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1308 WAUKEGAN RD STE 103, GLENVIEW, IL 60025-3070
(877) 486-4140
Mailing address
3161 N CAMBRIDGE AVE APT 206, CHICAGO, IL 60657-4602
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
4924-026
WI
225XP0200X
Pediatric Occupational Therapist
Primary
056009199
IL
Other
Enumeration date
10/15/2010
Last updated
10/22/2010
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