Individual
JERILYNN LEA HULTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
951 ESSINGTON RD, SUITE 400, JOLIET, IL 60435-8427
(815) 942-8301
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056-003243
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
056003243
LICENSE
IL
Enumeration date
06/10/2006
Last updated
11/06/2023
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