MIKE A CLARK

CHICAGO, IL
NPI1639370984
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225X00000X Occupational Therapist
(Licence: IL  056002647)
Additional Taxonomies225X00000X Occupational Therapist
(Licence: IN  31001679A)
Enumeration Date2007-05-31
Last Update Date2007-07-08
Business Address
-- MIKE A CLARK OT
444 N WELLS ST STE 304
CHICAGO, IL 60610-4593
Phone number: 708-757-5362
Mailing Address
-- MIKE A CLARK OT
23235 S VOLBRECHT RD
CRETE, IL 60417-1789
Phone number: 708-757-5362