Individual
KAITLIN S IBARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2917 N WISNER AVE APT 1, CHICAGO, IL 60618-6712
(150) 897-1010
Mailing address
2917 N WISNER AVE APT 1, CHICAGO, IL 60618-6712
(150) 897-1010
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056012106
IL
Other
Enumeration date
05/26/2018
Last updated
05/26/2018
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