Healthcare Provider Details

I. General information

NPI: 1710250022
Provider Name (Legal Business Name): KARIN LYNN SYKES OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/16/2012
Last Update Date: 02/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 MEDICAL CENTER DR
MONTICELLO IL
61856-2116
US

IV. Provider business mailing address

1000 MEDICAL CENTER DR
MONTICELLO IL
61856-2116
US

V. Phone/Fax

Practice location:
  • Phone: 217-454-1950
  • Fax: 217-762-1832
Mailing address:
  • Phone: 217-454-1950
  • Fax: 217-762-1832

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number056.002158
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: