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General NPI Number Information
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NPI Number | 1003325036
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Entity Type | Individual
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Provider Name | ELIZABETH ILLIG MOT, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 09/21/2017
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Last Update Date | 05/30/2023
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Provider Practice Location Address
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Address Line | 1811 GLENWOOD DR
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City | TWINSBURG
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State | OH
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Zip | 44087-1214
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Country | US
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Telephone | 440-488-8457
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Fax |
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Provider Business Mailing Address
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Address Line | 9968 PEBBLE BEACH CV
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City | AURORA
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State | OH
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Zip | 44202-8131
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 009201
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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