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General NPI Number Information
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NPI Number | 1093919102
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Entity Type | Individual
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Provider Name | ERIN D HOLDEN COTA
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Gender | Female
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Dates
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Enumeration Date | 06/13/2007
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Last Update Date | 03/09/2010
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Provider Practice Location Address
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Address Line | 2710 N CLARK ST
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City | CHICAGO
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State | IL
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Zip | 60614-1503
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Country | US
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Telephone | 773-348-3980
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Fax | 773-348-3980
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Provider Business Mailing Address
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Address Line | 4343 N CLARENDON AVE UNIT 1917
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City | CHICAGO
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State | IL
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Zip | 60613-2698
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Country | US
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Telephone | 773-935-0239
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 057.002535
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License Number State | IL
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