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NPI Code Detail

MEDICARE: MELISSA VAUGHAN PODRAZIK OTR/L

MEDICARE: MELISSA VAUGHAN PODRAZIK OTR/L
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 Therapist056.012653IL

General Provider Information

NPI Number : 1265917181
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA VAUGHAN PODRAZIK OTR/L
Provider Business Mailing Address
First Line : 410 N WINSTON DR
Second Line :
City : PALATINE
State : IL
Zip : 60074-4134
Country : US
Telephone Number : 847-281-6494
Fax Number :
Provider Business Practice Location Address
First Line : 1371 ABBOTT CT STE A
Second Line :
City : BUFFALO GROVE
State : IL
Zip : 60089-2367
Country : US
Telephone Number : 847-777-8995
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2018
Last Update Date : 01/31/2025

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Directions to “ MELISSA VAUGHAN PODRAZIK OTR/L” Practice Location

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