MEDICARE: KAREN A. MARKULIN

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	224Z00000X	Occupational Therapy Assistant	32003727A	IN

General Provider Information

NPI Number	:	1003688490
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN A. MARKULIN

Provider Business Mailing Address
First Line	:	13970 FLAGSTAFF ST
Second Line	:
City	:	CEDAR LAKE
State	:	IN
Zip	:	46303-7281
Country	:	US
Telephone Number	:	708-287-9991
Fax Number	:

Provider Business Practice Location Address
First Line	:	13970 FLAGSTAFF ST
Second Line	:
City	:	CEDAR LAKE
State	:	IN
Zip	:	46303-7281
Country	:	US
Telephone Number	:	708-287-9991
Fax Number	:

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

Provider Enumeration Date	:	10/27/2023
Last Update Date	:	10/27/2023

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