SearchIllinois261QR0400X

Marine Sutrisno, OTR/L

NPI 1073902417 · on the registry since 2015 · sole proprietor

Practice

Address
721 Crown Ct
Schaumburg, IL 60193
Phone
(312) 238-2460

Registry record

Primary taxonomy
261QR0400X
261QR0400X
Licence states on file
IL
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2015-01-22

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois