Healthcare Provider Details

I. General information

NPI: 1770349771
Provider Name (Legal Business Name): HANNAH MARQUEZ OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2024
Last Update Date: 02/27/2024
Certification Date: 02/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5140 N OAKLEY AVE
CHICAGO IL
60625-1847
US

IV. Provider business mailing address

5140 N OAKLEY AVE
CHICAGO IL
60625-1847
US

V. Phone/Fax

Practice location:
  • Phone: 616-633-3237
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XE0001X
TaxonomyEnvironmental Modification Occupational Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: