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General NPI Number Information
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NPI Number | 1083195424
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Entity Type | Individual
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Provider Name | ERIN CLAUSSEN CO
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Gender | Female
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Dates
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Enumeration Date | 08/23/2018
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Last Update Date | 08/23/2018
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Provider Practice Location Address
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Address Line | 225 E CHICAGO AVE # 46
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City | CHICAGO
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State | IL
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Zip | 60611-2991
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Country | US
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Telephone | 312-227-6210
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Fax |
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Provider Business Mailing Address
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Address Line | 2149 W ADDISON ST APT 2
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City | CHICAGO
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State | IL
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Zip | 60618-6135
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Country | US
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Telephone | 608-334-5706
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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 | 222Z00000X
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Taxonomy Name | Orthotist
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License Number | 213.000365
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 222Z00000X
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Taxonomy Name | Orthotist
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License Number | CO005808
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License Number State |
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