Healthcare Provider Details

I. General information

NPI: 1407110778
Provider Name (Legal Business Name): GAIL A ZIMMERMAN OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2012
Last Update Date: 01/10/2025
Certification Date: 01/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 DELAFIELD ST STE 120
WAUKESHA WI
53188-3417
US

IV. Provider business mailing address

2001 BUTTERFIELD RD STE 1600
DOWNERS GROVE IL
60515-1211
US

V. Phone/Fax

Practice location:
  • Phone: 262-521-9762
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number188-26
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: