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NPI Code Detail

MEDICARE: MS. KARIN GAIL DAVIS COTA

MEDICARE: MS. KARIN GAIL DAVIS COTA
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
1224Z00000XOccupational Therapy AssistantIL

General Provider Information

NPI Number : 1316164767
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KARIN GAIL DAVIS COTA
Provider Business Mailing Address
First Line : 7358 S GREEN ST
Second Line :
City : CHICAGO
State : IL
Zip : 60621-1614
Country : US
Telephone Number : 312-942-2786
Fax Number : 312-942-2086
Provider Business Practice Location Address
First Line : 1653 W CONGRESS PKWY
Second Line : 1325 KELLOGG
City : CHICAGO
State : IL
Zip : 60612-3833
Country : US
Telephone Number : 312-942-2786
Fax Number : 312-942-2086
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2007
Last Update Date : 07/08/2007

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