Healthcare Provider Details

I. General information

NPI: 1740806843
Provider Name (Legal Business Name): KATHERINE GRACE HARTSOOK OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATHERINE GRACE BYRNE

II. Dates (important events)

Enumeration Date: 06/24/2020
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 E SUPERIOR ST
CHICAGO IL
60611-2654
US

IV. Provider business mailing address

715 W WRIGHTWOOD AVE APT 1
CHICAGO IL
60614-7067
US

V. Phone/Fax

Practice location:
  • Phone: 312-238-6850
  • Fax:
Mailing address:
  • Phone: 405-606-9372
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number5446
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: