Individual
MRS. MODELYNE ESSIEN KANAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 SUNSET RIDGE RD, NORTHBROOK, IL 60062-4008
(224) 235-4639
Mailing address
5240 GALITZ ST APT 102, SKOKIE, IL 60077-2740
(847) 877-3252
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.005816
IL
Other
Enumeration date
07/27/2022
Last updated
07/27/2022
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