MEDICARE: VALERIE MAXWELL-SOFIYEA O.T.

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	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1215154828
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALERIE MAXWELL-SOFIYEA O.T.

Provider Business Mailing Address
First Line	:	1666 W 103RD ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60643-2819
Country	:	US
Telephone Number	:	773-233-0756
Fax Number	:	773-233-0756

Provider Business Practice Location Address
First Line	:	1666 W.103RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60643-2819
Country	:	US
Telephone Number	:	772-233-0756
Fax Number	:	773-233-0756

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

Provider Enumeration Date	:	04/18/2007
Last Update Date	:	08/21/2025

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