MEDICARE: ALYSE SESSELMANN M.S OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225XP0200X	Pediatric Occupational Therapist	056.010997	IL

General Provider Information

NPI Number	:	1336536903
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSE SESSELMANN M.S OTR/L

Provider Business Mailing Address
First Line	:	1739 N. ELSTON AVE.
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60642-1544
Country	:	US
Telephone Number	:	773-672-7775
Fax Number	:	773-305-5543

Provider Business Practice Location Address
First Line	:	1739 N. ELSTON AVE.
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60642-1544
Country	:	US
Telephone Number	:	773-672-7775
Fax Number	:	773-305-5543

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/22/2015
Last Update Date	:	09/30/2025

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