Healthcare Provider Details

I. General information

NPI: 1194259804
Provider Name (Legal Business Name): NATALIE MACHADO OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2017
Last Update Date: 07/08/2024
Certification Date: 07/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6501 S PROMONTORY DR
CHICAGO IL
60649-1003
US

IV. Provider business mailing address

6501 S PROMONTORY DR
CHICAGO IL
60649-1003
US

V. Phone/Fax

Practice location:
  • Phone: 773-363-6700
  • Fax: 773-348-2073
Mailing address:
  • Phone: 773-363-6700
  • Fax: 773-348-2073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number056011945
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: