Healthcare Provider Details

I. General information

NPI: 1831209790
Provider Name (Legal Business Name): NAYNA PUROHIT MOTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 S MILWAUKEE AVE
LIBERTYVILLE IL
60048-3204
US

IV. Provider business mailing address

550 W FULTON ST APT 508
CHICAGO IL
60661-1174
US

V. Phone/Fax

Practice location:
  • Phone: 847-367-3344
  • Fax: 847-549-6920
Mailing address:
  • Phone: 847-644-2385
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: