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General NPI Number Information
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NPI Number | 1003576620
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Entity Type | Individual
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Provider Name | ASHA RAO OTR/L
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Gender | Female
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Dates
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Enumeration Date | 12/22/2021
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Last Update Date | 12/22/2021
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Provider Practice Location Address
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Address Line | 6906 MASON HILL RD
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City | MCHENRY
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State | IL
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Zip | 60050-6411
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Country | US
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Telephone | 847-651-8083
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Fax | 773-303-8432
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Provider Business Mailing Address
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Address Line | 6906 MASON HILL RD
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City | MCHENRY
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State | IL
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Zip | 60050-6411
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Country | US
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Telephone | 847-651-8083
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Fax | 773-303-8432
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 056.014646
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License Number State | IL
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