Healthcare Provider Details

I. General information

NPI: 1356656169
Provider Name (Legal Business Name): ANNETTE M HATTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2010
Last Update Date: 01/11/2022
Certification Date: 12/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2176 GLADSTONE CT. SUITES A/B
GLENDALE HEIGHTS IL
60139-1600
US

IV. Provider business mailing address

145 S PROSPECT ST
ROSELLE IL
60172-2263
US

V. Phone/Fax

Practice location:
  • Phone: 630-715-0095
  • Fax: 630-582-4263
Mailing address:
  • Phone: 630-715-0095
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number056002227
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: ANNETTE HATTER
Title or Position: PRESIDENT
Credential: OTR/L
Phone: 630-715-0095