Healthcare Provider Details

I. General information

NPI: 1841440153
Provider Name (Legal Business Name): OLGA ROZIN-LEVIN OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: OLGA LEVIN OT

II. Dates (important events)

Enumeration Date: 09/23/2008
Last Update Date: 03/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1832 WENTZVILLE PKWY
WENTZVILLE MO
63385-3817
US

IV. Provider business mailing address

625 ENTERPRISE DR
OAK BROOK IL
60523-8813
US

V. Phone/Fax

Practice location:
  • Phone: 636-327-7110
  • Fax: 636-327-7135
Mailing address:
  • Phone: 630-575-1980
  • Fax: 630-928-5080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number1999141568
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: