Individual
JULIE HISKES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
14716 S EASTERN AVE, PLAINFIELD, IL 60544-8870
(815) 436-3400
Mailing address
18302 WALTER ST, LANSING, IL 60438-3232
(708) 899-0016
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057004895
IL
Other
Enumeration date
12/04/2018
Last updated
12/04/2018
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