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NPI Code Detail

MEDICARE: MRS. CAROL ANN COLLINS-WATTS OTR/L

MEDICARE: MRS. CAROL ANN COLLINS-WATTS 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 Therapist056.003851IL

General Provider Information

NPI Number : 1568782415
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CAROL ANN COLLINS-WATTS OTR/L
Provider Business Mailing Address
First Line : 5437 FAIR ELMS AVE
Second Line :
City : WESTERN SPRINGS
State : IL
Zip : 60558-1815
Country : US
Telephone Number : 708-453-0008
Fax Number :
Provider Business Practice Location Address
First Line : 7733 W GRAND AVE
Second Line :
City : ELMWOOD PARK
State : IL
Zip : 60707-1820
Country : US
Telephone Number : 708-453-0084
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2010
Last Update Date : 06/02/2010

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Directions to “ MRS. CAROL ANN COLLINS-WATTS OTR/L” Practice Location

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