MEDICARE: ANDREA KAREEM BS

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	056006583	IL

General Provider Information

NPI Number	:	1992846703
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA KAREEM BS

Provider Business Mailing Address
First Line	:	1200 S YORK RD
Second Line	:
City	:	ELMHURST
State	:	IL
Zip	:	60126-5626
Country	:	US
Telephone Number	:	630-758-8111
Fax Number	:	630-758-8387

Provider Business Practice Location Address
First Line	:	1200 S YORK ST STE 3200
Second Line	:
City	:	ELMHURST
State	:	IL
Zip	:	60126-5637
Country	:	US
Telephone Number	:	630-359-6888
Fax Number	:

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

Provider Enumeration Date	:	02/12/2007
Last Update Date	:	11/26/2019

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