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NPI Code Detail

MEDICARE: EMILY CLENDENNING

MEDICARE: EMILY CLENDENNING
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
1225X00000XOccupational Therapist

General Provider Information

NPI Number : 1194369405
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY CLENDENNING
Provider Business Mailing Address
First Line : 19100 CRESCENT DR STE 101
Second Line :
City : MOKENA
State : IL
Zip : 60448-7526
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 19100 CRESCENT DR STE 101
Second Line :
City : MOKENA
State : IL
Zip : 60448-7526
Country : US
Telephone Number : 708-478-5400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/30/2019
Last Update Date : 10/30/2019

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Directions to “ EMILY CLENDENNING ” Practice Location

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