Individual
KIMBERLY O'SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16170 KINGSPORT RD, ORLAND PARK, IL 60467-5602
(708) 349-6544
Mailing address
16170 KINGSPORT RD, ORLAND PARK, IL 60467-5602
(708) 349-6544
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056005717
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3640571036046701
—
IL
Enumeration date
10/13/2006
Last updated
04/14/2015
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