Individual
ANTONINA ROSARIA SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
10350 BRENNER CT, NAPERVILLE, IL 60564
(630) 664-6488
Mailing address
23837 ROYAL WORLINGTON DR, NAPERVILLE, IL 60564-8141
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056010433
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
056010433
LICENSE NUMBER
IL
Enumeration date
02/18/2014
Last updated
06/05/2018
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