Individual
MS. CARLY KUKISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT
Contact information
Practice address
929 W FOSTER AVE, CHICAGO, IL 60640-1491
(773) 433-1800
Mailing address
1937 W DIVERSEY PKWY APT 2E, CHICAGO, IL 60614-7844
(215) 896-4087
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.011736
IL
Other
Enumeration date
04/23/2014
Last updated
11/03/2016
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