Individual
SUSAN BOTTANDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
3703 W LAKE AVE, SUITE 200, GLENVIEW, IL 60026-1223
(847) 998-1188
Mailing address
4852 N DRAKE AVE, APT. 2, CHICAGO, IL 60625-5610
(773) 443-7524
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.004525
IL
Other
Enumeration date
07/14/2016
Last updated
07/14/2016
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