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Individual

ALYSSA ILLIAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
755 SKOKIE BLVD, NORTHBROOK, IL 60062-2805
(312) 238-3814
Mailing address
532 DUNSTEN CIR, NORTHBROOK, IL 60062-2611

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056008513
IL

Other

Enumeration date
10/31/2008
Last updated
10/31/2008
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