Individual
SABREEN DASSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 UNIVERSITY CIR, MACOMB, IL 61455-1367
(309) 298-3066
Mailing address
15232 LINDEN DR, OAK FOREST, IL 60452-1507
(708) 983-4580
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1073964086
—
IL
Enumeration date
06/30/2016
Last updated
01/10/2018
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