Individual
MS. HOLLY YVONNE LUSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
5601 W CERMAK RD, CICERO, IL 60804-2220
(708) 863-5700
Mailing address
5224 W WARNER AVE, CHICAGO, IL 60641-1469
(773) 545-6874
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.001324
IL
225XH1200X
Hand Occupational Therapist
056.001324
IL
Other
Enumeration date
10/09/2007
Last updated
10/09/2007
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