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1861602823
TIMOTHY WILD
ORLAND PARK, IL
NPI
1861602823
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: IL 057001263)
Enumeration Date
2007-05-22
Last Update Date
2007-07-08
Business Address
-- TIMOTHY WILD COTA
16170 KINGSPORT RD
ORLAND PARK, IL 60467-5602
Phone number: 708-349-6544
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Mailing Address
-- TIMOTHY WILD COTA
3818 N PARK ST
WESTMONT, IL 60559-1004
Phone number: 708-349-6544
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