Healthcare Provider Details

I. General information

NPI: 1003736828
Provider Name (Legal Business Name): ASHLEY ELIZABETH BAUER COTA/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 COMPASS RD
GLENVIEW IL
60026-8001
US

IV. Provider business mailing address

2600 COMPASS RD
GLENVIEW IL
60026-8001
US

V. Phone/Fax

Practice location:
  • Phone: 877-787-3430
  • Fax: 847-386-5190
Mailing address:
  • Phone: 877-787-3430
  • Fax: 847-386-5190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number5202008501
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: