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General NPI Number Information
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NPI Number | 1063207256
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Entity Type | Individual
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Provider Name | MADELYN ANN TEPE OTR/L
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Gender | Female
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Dates
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Enumeration Date | 04/10/2025
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Last Update Date | 04/10/2025
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Provider Practice Location Address
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Address Line | 2100 S FINLEY RD
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City | LOMBARD
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State | IL
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Zip | 60148-4830
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Country | US
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Telephone | 630-495-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 16W543 MOCKINGBIRD LN APT 104
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City | WILLOWBROOK
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State | IL
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Zip | 60527-6624
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Country | US
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Telephone | 618-719-5344
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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 | 056016528
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License Number State | IL
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