Individual
KASEY DIANA SISCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9018 HERITAGE PKWY STE 600, WOODRIDGE, IL 60517-5139
(630) 442-7662
Mailing address
1007 PARKWOOD DR APT B, JOLIET, IL 60432-3139
(708) 271-5311
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
08/12/2020
Last updated
11/14/2024
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