Individual
LIANA MERIAN ALIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
2625 W TOUHY AVE, CHICAGO, IL 60645-3109
(773) 973-5333
Mailing address
1630 N NEWLAND AVE, CHICAGO, IL 60707-4407
(773) 991-7135
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057000269
IL
Other
Enumeration date
06/28/2012
Last updated
06/28/2012
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