Individual
EMMA ROSE ILSEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
900 N WESTMORELAND RD STE LL50, LAKE FOREST, IL 60045-1694
(224) 271-5400
Mailing address
4117 BITTERNUT LN APT 207, GURNEE, IL 60031-2190
(331) 457-1360
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056014102
IL
Other
Enumeration date
11/18/2021
Last updated
11/18/2021
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