Individual
OLIVIA KOLOMIYETS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
634 ACADEMY DR, NORTHBROOK, IL 60062-2421
(224) 616-5439
Mailing address
6085 SWEETBAY DR, NORTH ROYALTON, OH 44133-3178
(440) 212-3297
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
056011997
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
056011997
ILLINOIS
IL
Enumeration date
06/13/2017
Last updated
06/13/2017
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