Individual
HEATHER SUNDARAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOTR/L
Contact information
Practice address
315 N LA GRANGE RD, LA GRANGE PARK, IL 60526-1903
(708) 354-3430
Mailing address
315 N LA GRANGE RD, LA GRANGE PARK, IL 60526-1903
(708) 354-3430
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056010669
IL
Other
Enumeration date
08/20/2014
Last updated
04/29/2017
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