Individual
ESSENCE DILDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1601 BUTTERFIELD TRL, KANKAKEE, IL 60901-2959
(815) 936-6500
Mailing address
21213 SHANNON AVE, MATTESON, IL 60443-1460
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.006080
IL
Other
Enumeration date
06/18/2024
Last updated
06/18/2024
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