MEDICARE: MRS. NICHOLE THOMPSON - CATO OTR

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
1	225X00000X	Occupational Therapist	31002624A	IN

General Provider Information

NPI Number	:	1932323177
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NICHOLE THOMPSON - CATO OTR

Provider Business Mailing Address
First Line	:	9231 S CREGIER AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60617-3602
Country	:	US
Telephone Number	:	773-343-0258
Fax Number	:	773-734-7802

Provider Business Practice Location Address
First Line	:	9231 S CREGIER AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60617-3602
Country	:	US
Telephone Number	:	773-343-0258
Fax Number	:	773-734-7802

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2007
Last Update Date	:	07/08/2007

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