Individual
MS. LISA KAY IFFLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
2417 W GLADYS AVE, CHICAGO, IL 60612-4806
(312) 733-8018
(773) 481-8892
Mailing address
2417 W GLADYS AVE, CHICAGO, IL 60612-4806
(312) 733-8018
(773) 481-8892
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056-001297
IL
225XP0200X
Pediatric Occupational Therapist
056-001297
IL
Other
Enumeration date
11/26/2016
Last updated
11/26/2016
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