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NPI Code Detail

MEDICARE: MS. REBECCA LYNN COVEN OTR/L

MEDICARE: MS. REBECCA LYNN COVEN 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 Therapist056000352IL

General Provider Information

NPI Number : 1548503634
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. REBECCA LYNN COVEN OTR/L
Provider Business Mailing Address
First Line : 2531 W CULLOM AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60618-1501
Country : US
Telephone Number : 773-539-5370
Fax Number :
Provider Business Practice Location Address
First Line : 2531 W CULLOM AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60618-1501
Country : US
Telephone Number : 773-539-5370
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2013
Last Update Date : 03/27/2013

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