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General NPI Number Information
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NPI Number | 1134663719
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Entity Type | Individual
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Provider Name | EMILY VON HOLT
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Gender | Female
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Dates
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Enumeration Date | 12/15/2016
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Last Update Date | 12/03/2020
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Provider Practice Location Address
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Address Line | 501 S BRIGHTON LN
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City | PALATINE
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State | IL
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Zip | 60067-5811
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Country | US
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Telephone | 224-800-9263
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Fax |
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Provider Business Mailing Address
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Address Line | 207 E HACKBERRY DR
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City | ARLINGTON HEIGHTS
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State | IL
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Zip | 60004-1513
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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 | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 056011608
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 056011608
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License Number State | IL
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