SearchIllinois224Z00000X

Kourtney Chalke, COTA/L

NPI 1407399165 · on the registry since 2016 · sole proprietor

Practice

Address
129 N Sycamore St
Centralia, IL 62801
Phone
(618) 335-4803

Registry record

Primary taxonomy
224Z00000X
224Z00000X
Licence states on file
IL
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2016-11-29

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois