Healthcare Provider Details

I. General information

NPI: 1902289796
Provider Name (Legal Business Name): AUDREY AKAI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2015
Last Update Date: 06/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16170 KINGSPORT RD
ORLAND PARK IL
60467-5602
US

IV. Provider business mailing address

16170 KINGSPORT RD QUALITY THERAPY & CONSULTATION, INC.
ORLAND PARK IL
60467-5602
US

V. Phone/Fax

Practice location:
  • Phone: 708-326-1550
  • Fax:
Mailing address:
  • Phone: 708-326-1550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XG0600X
TaxonomyGerontology Occupational Therapist
License Number056004247
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: