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NPI Code Detail

MEDICARE: REBECCA BROWN OT

MEDICARE: REBECCA BROWN 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 Therapist056-002911IL

General Provider Information

NPI Number : 1801833884
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA BROWN OT
Provider Business Mailing Address
First Line : 790 REMINGTON BLVD
Second Line :
City : BOLINGBROOK
State : IL
Zip : 60440-4909
Country : US
Telephone Number : 630-296-2223
Fax Number :
Provider Business Practice Location Address
First Line : 1226 S CANAL ST
Second Line :
City : CHICAGO
State : IL
Zip : 60607-5213
Country : US
Telephone Number : 312-733-8958
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2006
Last Update Date : 10/25/2010

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