Organization
FULFILLED ABILITY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAVEN LONG (OWNER)
(773) 844-7759
Entity
Organization
Contact information
Practice address
9816 S DREXEL AVE, CHICAGO, IL 60628-1530
(773) 844-7759
Mailing address
9816 S DREXEL AVE, CHICAGO, IL 60628-1530
(773) 844-7759
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
04/10/2025
Last updated
04/10/2025
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