Individual
SAVANNAH NICOLE SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7800 S KENTON AVE, CHICAGO, IL 60652-1131
(312) 801-0552
Mailing address
7800 S KENTON AVE, CHICAGO, IL 60652-1131
(312) 801-0552
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32003839A
IN
Other
Enumeration date
10/27/2023
Last updated
02/25/2024
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