Healthcare Provider Details

I. General information

NPI: 1700780897
Provider Name (Legal Business Name): HANNAH L EUGENE OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

213 BRIERHILL DR
ROUND LAKE PARK IL
60073-3427
US

IV. Provider business mailing address

213 BRIERHILL DR
ROUND LAKE PARK IL
60073-3427
US

V. Phone/Fax

Practice location:
  • Phone: 574-440-4358
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number056.027209
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: