Provider Demographics
NPI:1710536420
Name:DORSANO, ALICIA (OTR/L)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:DORSANO
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4846 FAIR ELMS AVE
Mailing Address - Street 2:
Mailing Address - City:WESTERN SPRINGS
Mailing Address - State:IL
Mailing Address - Zip Code:60558-1709
Mailing Address - Country:US
Mailing Address - Phone:708-285-3943
Mailing Address - Fax:
Practice Address - Street 1:18370 LIMESTONE CREEK RD
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-3860
Practice Address - Country:US
Practice Address - Phone:708-285-3943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-05
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist