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NPI Code Detail

MEDICARE: MS. JESSICA SEIDMAN OTR/L

MEDICARE:  MS. JESSICA  SEIDMAN  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 Therapist056010516IL

General Provider Information

NPI Number : 1770901522
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JESSICA SEIDMAN OTR/L
Provider Business Mailing Address
First Line : 1335 W ALTGELD ST APT 2F
Second Line :
City : CHICAGO
State : IL
Zip : 60614-6750
Country : US
Telephone Number : 847-989-6706
Fax Number :
Provider Business Practice Location Address
First Line : 1957 W DICKENS AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60614-3934
Country : US
Telephone Number : 773-789-9640
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2014
Last Update Date : 03/30/2014

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Directions to “ MS. JESSICA SEIDMAN OTR/L” Practice Location

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