Healthcare Provider Details

I. General information

NPI: 1336536903
Provider Name (Legal Business Name): ALYSE SESSELMANN M.S OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2015
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1739 N. ELSTON AVE.
CHICAGO IL
60642-1544
US

IV. Provider business mailing address

1739 N. ELSTON AVE.
CHICAGO IL
60642-1544
US

V. Phone/Fax

Practice location:
  • Phone: 773-672-7775
  • Fax: 773-305-5543
Mailing address:
  • Phone: 773-672-7775
  • Fax: 773-305-5543

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number056.010997
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: