Healthcare Provider Details

I. General information

NPI: 1407396724
Provider Name (Legal Business Name): HALINA BEDNARZ OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2017
Last Update Date: 03/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 W ALGONQUIN RD
ARLINGTON HEIGHTS IL
60005-4439
US

IV. Provider business mailing address

515 W ALGONQUIN RD
ARLINGTON HEIGHTS IL
60005-4439
US

V. Phone/Fax

Practice location:
  • Phone: 847-956-0388
  • Fax: 847-956-0379
Mailing address:
  • Phone: 847-956-0388
  • Fax: 847-956-0379

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number56010797
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: