Most Relevant Information
Provider Data
| NPI Number: | 1003585266 |
| Provider Name: | EMILY CLYSDALE |
| Entity Type: | Individual |
| Taxonomy Code: | 225XP0200X |
| Specialty: | Occupational Therapist |
| License Number: | 56014281 |
Most Important Dates
| Enumeration Date: | 09/10/2021 |
| Last Updated: | 09/10/2021 |
Provider Practice Location
420 W FRONTAGE RD STE 200
NORTHFIELD
IL
600933046
Practice Location Phone/Fax
| Phone: | 8477849115 |
| Fax: |
Provider Mailing Location
365 N HALSTED ST APT 1314
CHICAGO
IL
606611375
Provider Mailing Phone/Fax
| Phone: | 6513087291 |
| Fax: |