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NPI Code Detail

MEDICARE: MEGHAN SUMAN OT

MEDICARE: MEGHAN SUMAN OT
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 TherapistIL

General Provider Information

NPI Number : 1700081767
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGHAN SUMAN OT
Provider Business Mailing Address
First Line : 472 BELVEDERE LN
Second Line :
City : AURORA
State : IL
Zip : 60502-8616
Country : US
Telephone Number : 630-851-0461
Fax Number :
Provider Business Practice Location Address
First Line : 1804 CENTRE POINT CIR STE 102
Second Line :
City : NAPERVILLE
State : IL
Zip : 60563-4849
Country : US
Telephone Number : 630-955-1940
Fax Number : 630-955-1944
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2007
Last Update Date : 07/08/2007

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