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Individual

KAREN SULLIVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2710 N CLARK ST, CHICAGO, IL 60614-1503
(773) 244-0005
Mailing address
1601 W SCHOOL ST, CHICAGO, IL 60657-2140
(312) 659-0384

Taxonomy

Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
056002144
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
056002144
LIENCE
IL
Enumeration date
03/09/2010
Last updated
03/09/2010
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